WorldWideScience

Sample records for clinically integrated multi-professional

  1. Development and Integration of Professional Core Values Among Practicing Clinicians.

    Science.gov (United States)

    McGinnis, Patricia Quinn; Guenther, Lee Ann; Wainwright, Susan F

    2016-09-01

    The physical therapy profession has adopted professional core values, which define expected values for its members, and developed a self-assessment tool with sample behaviors for each of the 7 core values. However, evidence related to the integration of these core values into practice is limited. The aims of this study were: (1) to gain insight into physical therapists' development of professional core values and (2) to gain insight into participants' integration of professional core values into clinical practice. A qualitative design permitted in-depth exploration of the development and integration of the American Physical Therapy Association's professional core values into physical therapist practice. Twenty practicing physical therapists were purposefully selected to explore the role of varied professional, postprofessional, and continuing education experiences related to exposure to professional values. The Core Values Self-Assessment and résumé sort served as prompts for reflection via semistructured interviews. Three themes were identified: (1) personal values were the foundation for developing professional values, which were further shaped by academic and clinical experiences, (2) core values were integrated into practice independent of practice setting and varied career paths, and (3) participants described the following professional core values as well integrated into their practice: integrity, compassion/caring, and accountability. Social responsibility was an area consistently identified as not being integrated into their practice. The Core Values Self-Assessment tool is a consensus-based document developed through a Delphi process. Future studies to establish reliability and construct validity of the tool may be warranted. Gaining an in-depth understanding of how practicing clinicians incorporate professional core values into clinical practice may shed light on the relationship between core values mastery and its impact on patient care. Findings may

  2. Not just another multi-professional course! Part 2: nuts and bolts of designing a transformed curriculum for multi-professional learning.

    Science.gov (United States)

    Mayers, Pat; Alperstein, Melanie; Duncan, Madeleine; Olckers, Lorna; Gibbs, Trevor

    2006-03-01

    Multi-professional education has traditionally aimed to develop health professionals who are able to collaborate effectively in comprehensive healthcare delivery. The respective professions learn about their differences in order to work together, rather than developing unity in their commitment to a shared vision of professionalism and service. In this, the second of two papers, the 'nuts and bolts' or practicalities of designing a transformed curriculum for a multi-professional course with a difference is described. Guidelines for the curriculum design process, which seeks to be innovative, grounded in theory and relevant to the learning of the students and the ultimately the health of the patients, include: valuing education; gaining buy-in; securing buy-out; defining of roles; seeking consensus; negotiating difference and expediting decisions. The phases of the design process are described, as well as the educational outcomes envisaged during the process. Reflections of the designers, in particular on what it means to be a multi-professional team, and a reconceptualization of multi-professional education are presented as challenges for educators of health professionals.

  3. Multi-professional audit supports clinical governance in projecting and implementing a new stroke care area

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    Marco Masina

    2013-03-01

    Full Text Available Patients with acute stroke have better outcomes in terms of survival or regaining independence if they receive organized inpatient care in a specific setting (Stroke Unit, SU where a coordinated multidisciplinary team can ensure the best level of care. The clinical governance of an SU requires a systematic monitoring of diagnostic, clinical and therapeutic processes through a structured audit. The entire project and set up of a new SU in Bentivoglio, Italy, were based on a model that focused on multidisciplinary teamwork and clinical governance. An audit based on the Benjamin audit cycle followed every step of the set up of the new SU. Markers from national and international guidelines and from the Italian Regional Audit, together with a specific database were used. The audit showed a high level of care and a significant improvement in the majority of clinical, diagnostic and therapeutic parameters. Only a few markers (i.e. waiting times for ultrasound tomography and prescription of oral anticoagulation therapy required specific projects in order to improve the results. Our experience confirmed that a structured audit can support clinical governance of an SU by monitoring clinical processes and quality of care. Such an audit involves the whole professional team and shows the effects of any single actions. It also helps integration and co-operation among staff. Furthermore, a structured audit is a useful instrument for professional accountability for both qualitative and quantitative aspects of care.

  4. Integrating professional behavior development across a professional allied health curriculum.

    Science.gov (United States)

    Tsoumas, Linda J; Pelletier, Deborah

    2007-01-01

    Professional behaviors are an integral part of clinical practice in all allied health and medical fields. A systematic process for instruction, the education, and development of professional behaviors, cannot be taught in the same way that memorization of human anatomy or medical terminology is taught. One cannot expect professional behaviors to just appear in an individual upon graduation and entry into a health care field. Professional behavior development is an essential component of physical therapy professional education and is clearly defined through the guiding documents of the American Physical Therapy Association, which include 'A Normative Model of Physical Therapist Professional Education,' 'Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapists,' and the 'Guide to Physical Therapist Practice.' Building a comprehensive and progressive curricular thread for professional behaviors can pose a challenge for a professional program and the core faculty. This paper will present a curricular model of weaving professional behaviors into a core entry-level professional curriculum using a specific curricular thread, activities for different levels of students, and assessment at each point in the path. This paper will demonstrate the potential for universal application of a professional behaviors.

  5. Not just another multi-professional course! Part 1. Rationale for a transformative curriculum.

    Science.gov (United States)

    Duncan, Madeleine; Alperstein, Melanie; Mayers, Pat; Olckers, Lorna; Gibbs, Trevor

    2006-02-01

    Undergraduate inter- and multi-professional education has traditionally aimed to develop health professionals who are able to collaborate effectively in comprehensive healthcare delivery. The respective professions learn from and about each other through comparisons of roles, responsibilities, powers, duties and perspectives in order to promote integrated service. Described here is the educational rationale of a multi-professional course with a difference; one that injects value to undergraduate health professional education through the development of critical cross-field knowledge, skills and attitudes that unite rather than differentiate professions. The aim of this course, offered at the Faculty of Health Sciences, University of Cape Town, is to lay an integrated, pan-professional foundation for the advancement of collective commitment to and understanding of national health and social development objectives such as primary health care, human rights and professionalism. Pan-professional refers to curriculum content that is core and of critical relevance to all participating professions. What is learned, how it is learned, how learning is facilitated and how it is applied, has been co-constructed by a multi-professional design team representing a range of health professions (audiology, medicine, occupational therapy, nursing, physiotherapy and speech therapy) and academic disciplines (anthropology, sociology, psychology, history, African studies and social development, information technology and language literacy). Education specialists facilitate the ongoing design process ensuring that the structure and content of the curriculum complies with contemporary adult learning principles and national higher education imperatives. Designing the original curriculum required the deconstruction of intra-professional and disciplinary canons of knowledge and ways of 'doing things' in order to identify and develop shared interpretations of critical epistemology and axiology

  6. Leading multi-professional teams in the children's workforce: an action research project.

    Science.gov (United States)

    Stuart, Kaz

    2012-01-01

    The 2004 Children Act in the UK saw the introduction of integrated working in children's services. A raft of change followed with processes designed to make joint working easier, and models and theories to support the development of integrated work. This paper explores the links between key concepts and practice. A practitioner action research approach is taken using an autoethnographic account kept over six months. The research question was, to what extent is this group collaborating? When the architecture of practice was revealed, differences between espoused and real practice could be seen. Whilst understanding and displaying the outward signs of an effective multi professional group, the individuals did not trust one another. This was exhibited by covert interprofessional issues. As a result, collaborative inertia was achieved. This realisation prompted them to participate in further developmental and participative action research. The paper concludes that trust and relational agency are central to effective leadership of multi professional teams.

  7. Multi-professional communication for older people in transitional care: a review of the literature.

    Science.gov (United States)

    Allen, Jacqui; Ottmann, Goetz; Roberts, Gail

    2013-12-01

    To synthesise research-reporting literature about multi-professional communication between health and social care professionals within transitional care for older people, with particular attention on outcomes, enabling contextual factors and constraints. Older adults experience high rates of morbidity and health care usage, and frequently transit between health services, and community and social care providers. These transition episodes place elders at increased risk of adverse incidents due to poor communication of information. Integrated multi-professional models of care built on enhanced communication have been widely promoted as a strategy to improve transitional care for older people. However, a range of findings exist in the literature to guide service providers and researchers. Comprehensive literature search and review strategies were employed to identify, describe and synthesise relevant studies. Ten databases were searched in addition to Google Scholar. Specified discharge worker roles, multi-professional care coordination teams, and information technology systems promote better service satisfaction and subjective quality of life for older people when compared with standard hospital discharge. Improved multi-professional communication reduces rates of re-admission and length of stay indicating greater cost effectiveness and efficiency for the health and social care systems. Systems of care emphasizing information exchange, education and negotiation between stakeholders facilitate communication in transitional care contexts for older adults. Conversely, lack of dialogue and lack of understanding of others' roles are barriers to communication in transitional care. Enhanced multi-professional communication, transitional pathways, and role clarity are required to improve the quality, sustainability and responsiveness of aged care into the future. Recommendations for further research include: (i) Investigation of pathways promoting person-centred care planning

  8. Stochastic integer programming for multi-disciplinary outpatient clinic planning

    NARCIS (Netherlands)

    Leeftink, A. G.; Vliegen, I. M.H.; Hans, E. W.

    2017-01-01

    Scheduling appointments in a multi-disciplinary clinic is complex, since coordination between disciplines is required. The design of a blueprint schedule for a multi-disciplinary clinic with open access requirements requires an integrated optimization approach, in which all appointment schedules are

  9. Leading multi-professional teams in the children’s workforce: an action research project

    Directory of Open Access Journals (Sweden)

    Karen Stuart

    2012-01-01

    Full Text Available Introduction: The 2004 Children Act in the UK saw the introduction of integrated working in children's services. A raft of change followed with processes designed to make joint working easier, and models and theories to support the development of integrated work. This paper explores the links between key concepts and practice.Methods: A practitioner action research approach is taken using an autoethnographic account kept over six months. The research question was, to what extent is this group collaborating?Results: When the architecture of practice was revealed, differences between espoused and real practice could be seen. Whilst understanding and displaying the outward signs of an effective multi professional group, the individuals did not trust one another. This was exhibited by covert interprofessional issues. As a result, collaborative inertia was achieved. This realisation prompted them to participate in further developmental and participative action research.Conclusion: The paper concludes that trust and relational agency are central to effective leadership of multi professional teams.

  10. Leading multi-professional teams in the children’s workforce: an action research project

    Directory of Open Access Journals (Sweden)

    Karen Stuart

    2012-01-01

    Full Text Available Introduction: The 2004 Children Act in the UK saw the introduction of integrated working in children's services. A raft of change followed with processes designed to make joint working easier, and models and theories to support the development of integrated work. This paper explores the links between key concepts and practice. Methods: A practitioner action research approach is taken using an autoethnographic account kept over six months. The research question was, to what extent is this group collaborating? Results: When the architecture of practice was revealed, differences between espoused and real practice could be seen. Whilst understanding and displaying the outward signs of an effective multi professional group, the individuals did not trust one another. This was exhibited by covert interprofessional issues. As a result, collaborative inertia was achieved. This realisation prompted them to participate in further developmental and participative action research. Conclusion: The paper concludes that trust and relational agency are central to effective leadership of multi professional teams.

  11. Multi-professional clinical medication reviews in care homes for the elderly: study protocol for a randomised controlled trial with cost effectiveness analysis

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    Sach Tracey

    2011-10-01

    Full Text Available Abstract Background Evidence demonstrates that measures are needed to optimise therapy and improve administration of medicines in care homes for older people. The aim of this study is to determine the clinical and cost effectiveness of a novel model of multi-professional medication review. Methods A cluster randomised controlled trial design, involving thirty care homes. In line with current practice in medication reviews, recruitment and consent will be sought from general practitioners and care homes, rather than individual residents. Care homes will be segmented according to size and resident mix and allocated to the intervention arm (15 homes or control arm (15 homes sequentially using minimisation. Intervention homes will receive a multi-professional medication review at baseline and at 6 months, with follow-up at 12 months. Control homes will receive usual care (support they currently receive from the National Health Service, with data collection at baseline and 12 months. The novelty of the intervention is a review of medications by a multi-disciplinary team. Primary outcome measures are number of falls and potentially inappropriate prescribing. Secondary outcome measures include medication costs, health care resource use, hospitalisations and mortality. The null hypothesis proposes no difference in primary outcomes between intervention and control patients. The primary outcome variable (number of falls will be analysed using a linear mixed model, with the intervention specified as a fixed effect and care homes included as a random effect. Analyses will be at the level of the care home. The economic evaluation will estimate the cost-effectiveness of the intervention compared to usual care from a National Health Service and personal social services perspective. The study is not measuring the impact of the intervention on professional working relationships, the medicines culture in care homes or the generic health-related quality of life of

  12. Developing health science students into integrated health professionals: a practical tool for learning

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    Duncan Madeleine

    2007-11-01

    Full Text Available Abstract Background An integrated sense of professionalism enables health professionals to draw on relevant knowledge in context and to apply a set of professional responsibilities and ethical principles in the midst of changing work environments 12. Inculcating professionalism is therefore a critical goal of health professional education. Two multi-professional courses for first year Health Science students at the University of Cape Town, South Africa aim to lay the foundation for becoming an integrated health professional 3. In these courses a diagram depicting the domains of the integrated health professional is used to focus the content of small group experiential exercises towards an appreciation of professionalism. The diagram serves as an organising framework for conceptualising an emerging professional identity and for directing learning towards the domains of 'self as professional' 45. Objective This paper describes how a diagrammatic representation of the core elements of an integrated health professional is used as a template for framing course content and for organising student learning. Based on the assumption that all health care professionals should be knowledgeable, empathic and reflective, the diagram provides students and educators with a visual tool for investigating the subjective and objective dimensions of professionalism. The use of the diagram as an integrating point of reference for individual and small group learning is described and substantiated with relevant literature. Conclusion The authors have applied the diagram with positive impact for the past six years with students and educators reporting that "it just makes sense". The article includes plans for formal evaluation. Evaluation to date is based on preliminary, informal feedback on the value of the diagram as a tool for capturing the domains of professionalism at an early stage in the undergraduate education of health professional students.

  13. Factors affecting integration of midwifery nursing science theory with clinical practice in Vhembe District, Limpopo Province as perceived by professional midwives.

    Science.gov (United States)

    Malwela, Thivhulawi; Maputle, Sonto M; Lebese, Rachel T

    2016-05-24

    Professional midwives have an important role to play in midwifery training to produce a competent midwife. According to the social learning theory, professional midwives act as role models for students. When allocated for clinical learning experiences in the training hospitals, students will have the opportunity to observe the well-trained, skilled, and experienced professional midwives. The whole process will enable students to integrate theory with practice and they will become competent. The aim of this study was to determine the factors affecting integration of midwifery nursing science theory with clinical practice as perceived by midwives. The study was conducted at the training hospitals in Vhembe district of the Limpopo Province, South Africa. These hospitals were: Donald Fraser, Siloam, and Tshidzini. A qualitative explorative, descriptive and contextual design was used. A Nonprobability, convenient sampling method was used to select 11 midwives from the following hospitals: Donald Fraser, Siloam, and Tshidzini, in Vhembe district. In-depth individual interviews were conducted. Data were analysed through open coding method. One theme and five sub-themes emerged from the analysed data, namely: shortage of midwives, attitudes towards student midwives, reluctance to perform teaching functions, language barriers, and declining midwifery practice standards. Shortage of midwives in the clinical areas led to fewer numbers of mentors whom the students could observe and imitate to acquire clinical skills. Some of the midwives were reluctant to teach students. Recommendations were made for both training institutions and hospitals to employ preceptors for students in the clinical practical.

  14. Refining and validating a conceptual model of Clinical Nurse Leader integrated care delivery.

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    Bender, Miriam; Williams, Marjory; Su, Wei; Hites, Lisle

    2017-02-01

    To empirically validate a conceptual model of Clinical Nurse Leader integrated care delivery. There is limited evidence of frontline care delivery models that consistently achieve quality patient outcomes. Clinical Nurse Leader integrated care delivery is a promising nursing model with a growing record of success. However, theoretical clarity is necessary to generate causal evidence of effectiveness. Sequential mixed methods. A preliminary Clinical Nurse Leader practice model was refined and survey items developed to correspond with model domains, using focus groups and a Delphi process with a multi-professional expert panel. The survey was administered in 2015 to clinicians and administrators involved in Clinical Nurse Leader initiatives. Confirmatory factor analysis and structural equation modelling were used to validate the measurement and model structure. Final sample n = 518. The model incorporates 13 components organized into five conceptual domains: 'Readiness for Clinical Nurse Leader integrated care delivery'; 'Structuring Clinical Nurse Leader integrated care delivery'; 'Clinical Nurse Leader Practice: Continuous Clinical Leadership'; 'Outcomes of Clinical Nurse Leader integrated care delivery'; and 'Value'. Sample data had good fit with specified model and two-level measurement structure. All hypothesized pathways were significant, with strong coefficients suggesting good fit between theorized and observed path relationships. The validated model articulates an explanatory pathway of Clinical Nurse Leader integrated care delivery, including Clinical Nurse Leader practices that result in improved care dynamics and patient outcomes. The validated model provides a basis for testing in practice to generate evidence that can be deployed across the healthcare spectrum. © 2016 John Wiley & Sons Ltd.

  15. An Integrative Professional Theory and Practice Paper: Personal Reflections from the Journey through Clinical Pastoral Education.

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    McLean, Gillian

    2015-12-01

    CPE is an experience-based approach to learning spiritual care which combines clinical care with qualified supervision, in-class education and group reflection (CASC--http://www.spiritualcare.ca/). Through didactic seminars, group presentations and personal reading there is opportunity for the student to acquire, apply and integrate relevant theoretical information into their practice. Written for my CPE Specialist application, this paper describes how, through the course of advanced CPE education, I learn to utilize and integrate theory into my clinical work. Beginning with three strands--authenticity, listening and storytelling--I then discuss how the behavioural sciences and theology inform my practice. Focusing on empathy, I speak of the application of disclosure, the use of counter-transference as a diagnostic tool, and the place of therapeutic termination. Group theory, family systems theory, theological reflection, liturgical ministry, and multi-faith practices are considered. © The Author(s) 2015.

  16. Clinical laboratory technologist professional development in Camagüey

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    Mercedes Caridad García González

    2015-05-01

    Full Text Available The paper describes the results of research aimed at assessing the current conditions related to clinical laboratory technologist professional development. A descriptive cross study covering the period between November 2013 and January 2014 is presented. Several techniques for identifying and hierarchically arranging professional developmental related problems were used to study a sample at the Faculty of Health Technology of the Medical University “Carlos Juan Finlay”. The study involved heads of teaching departments and methodologists of health care technology specialties; moreover a survey and a content test were given graduate clinical laboratory technicians. The authors reached at the conclusion that clinical laboratory technologist professional development is limited and usually underestimate the necessities and interests of these graduates. Likewise, a lack of systematization and integration of the biomedical basic sciences contents and the laboratory diagnosis is noticeable.

  17. Opinions of professionals about integrating midwife- and obstetrician-led care in The Netherlands.

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    Perdok, Hilde; Jans, Suze; Verhoeven, Corine; van Dillen, Jeroen; Batenburg, Ronald; Mol, Ben Willem; Schellevis, François; de Jonge, Ank

    2016-06-01

    the current division between midwife-led and obstetrician-led care creates fragmentation in maternity care in the Netherlands. This study aims to gain insight into the level of consensus among maternity care professionals about facilitators and barriers related to integration of midwife-led and obstetrician-led care. Integration could result in more personal continuity of care for women who are referred during labour. This may lead to better birth experiences, fewer interventions and better outcomes for both mother and infant. a descriptive study using a questionnaire survey of 300 primary care midwives, 100 clinical midwives and 942 obstetricians. the Netherlands in 2013. 131 (response 44%) primary care midwives, 51 (response 51%) clinical midwives and 242 (response 25%) obstetricians completed the questionnaire. there was consensus about the clinical midwife caring for labouring women at moderate risk of complications. Although primary care midwives themselves were willing to expand their tasks there was no consensus among respondents on the tasks and responsibilities of the primary care midwife. Professionals agreed on the importance of good collaboration between professionals who should work together as a team. Respondents also agreed that there are conflicting interests related to the payment structure, which are a potential barrier for integrating maternity care. this study shows that professionals are positive regarding an integrated maternity care system but primary care midwives, clinical midwives and obstetricians have different opinions about the specifications and implementation of this system. our findings are in accordance with earlier research, showing that it is too early to design a blueprint for an integrated maternity care model in the Netherlands. To bring about change in the maternity care system, an implementation strategy should be chosen that accounts for differences in interests and opinions between professionals. Copyright © 2016 Elsevier

  18. Professional nurses' understanding of clinical judgement: A contextual inquiry

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    Anna C. van Graan

    2016-12-01

    Full Text Available Higher cognitive skills are essential competencies for nurses joining the technologically and increasingly complex health care environment to provide safe and effective nursing care. Educators and clinical facilitators have recognised that newly qualified nurses do not meet the expectations for entry level clinical judgement and are held accountable for finding adequate learning experiences as preparation for such practice demands. An explorative and descriptive qualitative design was followed in this study to reach an understanding of clinical judgement in the clinical nursing environment from the perspective of professional nurses. Eleven professional nurses (n = 11 working at primary health care clinics, public and private hospitals participated voluntarily. Data was collected by means of the “World Café” method, incorporating a combination of techniques such as interviewing, discussions, drawings, narratives and reflection. The focus was on professional nurses' knowledge of the meaning of clinical judgement and factors influencing the development of clinical judgement in the clinical environment. Qualitative thematic content analysis principles were applied during data analysis. The findings were integrated with the relevant literature to culminate in conclusions that should add to the knowledge base of clinical judgement as an essential skill for improving autonomous and accountable nursing care.

  19. Professional nurses' understanding of clinical judgement: A contextual inquiry

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    Anna C. van Graan

    2016-10-01

    Full Text Available Higher cognitive skills are essential competencies for nurses joining the technologically and increasingly complex health care environment to provide safe and effective nursing care. Educators and clinical facilitators have recognised that newly qualified nurses do not meet the expectations for entry level clinical judgement and are held accountable for finding adequate learning experiences as preparation for such practice demands. An explorative and descriptive qualitative design was followed in this study to reach an understanding of clinical judgement in the clinical nursing environment from the perspective of professional nurses. Eleven professional nurses (n = 11 working at primary health care clinics, public and private hospitals participated voluntarily. Data was collected by means of the “World Cafe” method, incorporating a combination of techniques such as interviewing, discussions, drawings, narratives and reflection. The focus was on professional nurses' knowledge of the meaning of clinical judgement and factors influencing the development of clinical judgement in the clinical environment. Qualitative thematic content analysis principles were applied during data analysis. The findings were integrated with the relevant literature to culminate in conclusions that should add to the knowledge base of clinical judgement as an essential skill for improving autonomous and accountable nursing care.

  20. A participatory assessment of IS integration needs in maternity clinics using activity theory.

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    Häkkinen, Heidi; Korpela, Mikko

    2007-01-01

    The design and development of information systems should focus on a wider context than merely one user group or organization. This is particularly the case with systems integration. A tentative description of the activity network, information needs, and user requirements should be acquired before any major changes are planned. Relatively rapid yet participatory methods are needed at this preliminary stage. In this article, we claim that activity theory offers a suitable framework for this. Subsequently, we present a qualitative study in which this approach was used, with focus on the practices of the information management within a maternity care activity network. The first aim was to elicit the most important integration needs in the existing information systems of Finnish maternity clinics. Secondly, we wanted to introduce a participatory approach to be utilized by the service-providing organizations themselves, rather than software companies or quality consultants. Data were collected in multi-professional group interviews. The results include information needs and communication problems as well as outlines for solutions in the systems integration of maternity clinics. Various tools of information management do not meet the concrete needs of health care work. Integration is needed on many levels, and it has to be adapted to the needs of numerous stakeholders. The applied activity-theoretical framework proved useful in describing such a multi-faceted system of information and its users. More research is needed on its wider applicability, particularly in situations where researchers are not active participants.

  1. Evaluation of multi-professional obstetric skills training for postpartum hemorrhage

    DEFF Research Database (Denmark)

    Markova, Veronika; Sørensen, Jette Led; Holm, Charlotte

    2012-01-01

    To evaluate the effect of multi-professional obstetric skills training on the incidence of postpartum hemorrhage (PPH) indicated by red blood cell (RBC) transfusion and time delay in surgical interventions before, during, and after implementation of the training.......To evaluate the effect of multi-professional obstetric skills training on the incidence of postpartum hemorrhage (PPH) indicated by red blood cell (RBC) transfusion and time delay in surgical interventions before, during, and after implementation of the training....

  2. Identifying the professional knowledge base for multi-grade teaching ...

    African Journals Online (AJOL)

    This paper reports a small-scale qualitative study of teachers and teaching principals in multi-grade rural schools in Australia, focusing on identifying the professional knowledge base required for teachers in such contexts. Such a knowledge base is essential for improving the quality of multi-grade teaching. Interviews and ...

  3. Professional ethics in nursing: an integrative review.

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    Kangasniemi, Mari; Pakkanen, Piiku; Korhonen, Anne

    2015-08-01

    To conduct an integrative review and synthesize current primary studies of professional ethics in nursing. Professional ethics is a familiar concept in nursing and provides an ethical code for nursing practice. However, little is known about how professional ethics has been defined and studied in nursing science. Systematic literature searches from 1948-February 2013, using the CINAHL, PubMed and Scopus electronic databases to look at previously published peer-reviewed studies. A modified version of Cooper's five-stage integrative review was used to review and synthesize current knowledge. Fourteen papers were included in this research. According to our synthesis, professional ethics is described as an intra-professional approach to care ethics and professionals commit to it voluntarily. Professional ethics consist of values, duties, rights and responsibilities, regulated by national legislation and international agreements and detailed in professional codes. Professional ethics is well established in nursing, but is constantly changing due to internal and external factors affecting the profession. Despite the obvious importance of professional ethics, it has not been studied much in nursing science. Greater knowledge of professional ethics is needed to understand and support nurses' moral decision-making and to respond to the challenges of current changes in health care and society. © 2015 John Wiley & Sons Ltd.

  4. Professional integrity of teachers in Uganda : Practical action strategies

    NARCIS (Netherlands)

    Wabule, Alice

    2017-01-01

    The study analyses the problem of professional integrity of teachers in Uganda and explores solutions. It analyses the difficult conditions under which Ugandan teachers work, reports on the professional dilemmas that they face, and on the serious issues of failings of professional integrity. The

  5. Principles and strategies for monitoring data collection integrity in a multi-site randomized clinical trial of a behavioral intervention.

    Science.gov (United States)

    Phillips-Salimi, Celeste R; Donovan Stickler, Molly A; Stegenga, Kristin; Lee, Melissa; Haase, Joan E

    2011-08-01

    Although treatment fidelity strategies for enhancing the integrity of behavioral interventions have been well described, little has been written about monitoring data collection integrity. This article describes the principles and strategies developed to monitor data collection integrity of the "Stories and Music for Adolescent/Young Adult Resilience During Transplant" study (R01NR008583, U10CA098543, and U10CA095861)-a multi-site Children's Oncology Group randomized clinical trial of a music therapy intervention for adolescents and young adults undergoing stem cell transplant. The principles and strategies outlined in this article provide one model for development and evaluation of a data collection integrity monitoring plan for behavioral interventions that may be adapted by investigators and may be useful to funding agencies and grant application reviewers in evaluating proposals. Copyright © 2011 Wiley Periodicals, Inc.

  6. THE INTEGRATION OF EDUCATION IN MULTI-RACIAL AND MULTI-CULTURAL SOCIETY

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    Chamisah Chamisah

    2017-07-01

    Full Text Available This study aims to know the reasons of education ina multi-racial and multi-cultural society demands integration.. The studywhich focuses onMalaysia country typified by three major ethnic groups, namely Malays, Chinese and Indians,foundthat, firstlythe integration of curriculum in creating a holistic education isvital for the society to create a competitive human capital with value laden such as trustworthiness, dedication, creativity, civic awareness and many more. Secondly, integration curriculum emphasizes on the equity and equality of education for all.Through interacting with individuals from a range of religious and ethnic backgrounds, people will learn to understand, accept and embrace differences. Throughsharing experiences and aspirations,a common national identity and ultimately unity can be achieved. Therefore, integrating curriculum is not only to integrate Islamic concepts in the education system but alsoto integrate all the concepts that make one comprehensive curriculum. Thirdly, it is important to integrate the curriculum with a value-laden perspective to encourage solidarity and harmony. Keywords: Multi-racial; Multi-cultural society; Education; Malaysia

  7. Integralidade e transdisciplinaridade em equipes multiprofissionais na saúde coletiva Integrality and transdisciplinarity in multi-professional teams in collective health

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    Silvani Botlender Severo

    2010-06-01

    Full Text Available Este artigo traz uma discussão e reflexão sobre a ativação da integralidade no processo de trabalho das equipes multiprofissionais na saúde coletiva. Alicerçamo-nos na teoria da complexidade de Edgar Morin e na lógica transdisciplinar de Basarab Nicolescu para compreender os paradoxos na ação coletiva dos trabalhadores no desafio de integrar as formações disciplinares com a exigência na prática de processos inter/transdisciplinares. Os trabalhadores encontram dificuldades na reorientação do modelo assistencial na saúde quando sua lógica está centrada na doença.This article brings about both a discussion and reflection on the activation of integrality in the work process of multi-professional teams in collective health. It has been grounded on the theory of complexity, by Edgar Morin, as well as on the transdisciplinary logic, by Basarab Nicolescu, to understand paradoxes in the collective action of workers when challenged to integrate disciplinary formations with the practice requirement of inter/transdisciplinary processes. Workers have found difficulty in reorienting the health assisting model whenever their logic is focused on illness.

  8. Permanent health education based on research with professionals of a multidisciplinary residency program: case study

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    Cristiane Trivisiol da Silva

    Full Text Available This research aims to identify the perception of professional members of a multi-professional residency program on Permanent Health Education. It is a case study research using a qualitative approach, with sixteen members of a multi-professional residency program. The data were collected from January to May 2012, through semi-structured interviews, document analysis and systematic observation, and analyzed according to Thematic Content Analysis. Two categories were identified: Permanent Health Education establishing collective spaces of reflection of practices and Permanent Health Education that promotes integration between disciplines. The members of the multiprofessional residency team were found to be aware that permanent education permeates their training and enables reflection on their clinical practices and multidisciplinary action as producers of health actions.

  9. Intelligent Multi-Media Integrated Interface Project

    Science.gov (United States)

    1990-06-01

    been devoted to the application of aritificial intelligence technology to the development of human -computer interface technology that integrates speech...RADC-TR-90-128 Final Technical Report June 1090 AD-A225 973 INTELLIGENT MULTI-MEDIA INTEGRATED INTERFACE PROJECT Calspan-University of Buffalo...contractual obligations or notices on a specific document require that it be returned. INTELLIGENT MULTI-MEDIA INTEGRATED INTERFACE PROJECT J. G. Neal J. M

  10. Professional approaches in clinical judgements among senior and junior doctors: implications for medical education

    Directory of Open Access Journals (Sweden)

    Pilhammar Ewa

    2009-05-01

    Full Text Available Abstract Background Clinical experience has traditionally been highly valued in medical education and clinical healthcare. On account of its multi-faceted nature, clinical experience is mostly difficult to articulate, and is mainly expressed in clinical situations as professional approaches. Due to retirement, hospitals in Scandinavia will soon face a substantial decrease in the number of senior specialist doctors, and it has been discussed whether healthcare will suffer an immense loss of experienced-based knowledge when this senior group leaves the organization. Both senior specialists and junior colleagues are often involved in clinical education, but the way in which these two groups vary in professional approaches and contributions to clinical education has not been so well described. Cognitive psychology has contributed to the understanding of how experience may influence professional approaches, but such studies have not included the effect of differences in position and responsibilities that junior and senior doctors hold in clinical healthcare. In the light of the discussion above, it is essential to describe the professional approaches of senior doctors in relation to those of their junior colleagues. This study therefore aims to describe and compare the professional approaches of junior and senior doctors when making clinical judgements. Methods Critical incident technique was used in interviews with nine senior doctors and nine junior doctors in internal medicine. The interviews were subjected to qualitative content analysis. Result Senior and junior doctors expressed a variety of professional approaches in clinical judgement as follows: use of theoretical knowledge, use of prior experience of cases and courses of events, use of ethical and moral values, meeting and communicating with the patient, focusing on available information, relying on their own ability, getting support and guidance from others and being directed by the

  11. Clinical educators' self-reported personal and professional ...

    African Journals Online (AJOL)

    The target group was inter-professional clinical educators that are involved in student education on the clinical platform. Although the course participants were professionals and specialists in their own fields, the majority of clinical educators have very little or no knowledge of adult education. The Supervision Course aims to ...

  12. A New Multi-Sensor Track Fusion Architecture for Multi-Sensor Information Integration

    National Research Council Canada - National Science Library

    Jean, Buddy H; Younker, John; Hung, Chih-Cheng

    2004-01-01

    .... This new technology will integrate multi-sensor information and extract integrated multi-sensor information to detect, track and identify multiple targets at any time, in any place under all weather conditions...

  13. The need for European professional standards and the challenges facing clinical microbiology.

    Science.gov (United States)

    Humphreys, H; Nagy, E; Kahlmeter, G; Ruijs, G J H M

    2010-06-01

    Microorganisms spread across national boundaries and the professional activities of clinical (medical) microbiologists are critical in minimising their impact. Clinical microbiologists participate in many activities, e.g. diagnosis, antibiotic therapy, and there is a need for a set of professional standards for Europe with a common curriculum, to build upon the current strengths of the specialty and to facilitate the free movement of specialists within the European Union. Such standards will also better highlight the important contribution of clinical microbiologists to healthcare. There is a move to larger centralised microbiology laboratories often located off-site from an acute hospital, driven by the concentration of resources, amalgamation of services, outsourcing of diagnostics, automation, an explosion in the range of staff competencies and accreditation. Large off-site centralised microbiology laboratories are often distant to the patient and may not facilitate the early detection of microbial spread. Ultimately, the needs of patients and the public are paramount in deciding on the future direction of clinical microbiology. Potential conflicts between integration on an acute hospital site and centralisation can be resolved by a common set of professional standards and a team-based approach that puts patients first.

  14. The Integration of Education in Multi-racial and Multi-cultural Society

    OpenAIRE

    Chamisah, Chamisah; M. Daud, Ridhwan

    2016-01-01

    This study aims to know the reasons of education ina multi-racial and multi-cultural society demands integration.. The studywhich focuses onMalaysia country typified by three major ethnic groups, namely Malays, Chinese and Indians,foundthat, firstlythe integration of curriculum in creating a holistic education isvital for the society to create a competitive human capital with value laden such as trustworthiness, dedication, creativity, civic awareness and many more. Secondly, integration curr...

  15. Integrating Personal and Professional Development.

    Science.gov (United States)

    Lippitt, Gordon L.

    1980-01-01

    The author outlines ways to integrate work identity and social identity in order to improve the quality of life. He presents a model for maintaining balance between personal and professional growth, which can stimulate achievement in six areas of human potential. (SK)

  16. Identifying professionals' needs in integrating electronic pain monitoring in community palliative care services: An interview study.

    Science.gov (United States)

    Taylor, Sally; Allsop, Matthew J; Bekker, Hilary L; Bennett, Michael I; Bewick, Bridgette M

    2017-07-01

    Poor pain assessment is a barrier to effective pain control. There is growing interest internationally in the development and implementation of remote monitoring technologies to enhance assessment in cancer and chronic disease contexts. Findings describe the development and testing of pain monitoring systems, but research identifying the needs of health professionals to implement routine monitoring systems within clinical practice is limited. To inform the development and implementation strategy of an electronic pain monitoring system, PainCheck, by understanding palliative care professionals' needs when integrating PainCheck into routine clinical practice. Qualitative study using face-to-face interviews. Data were analysed using framework analysis Setting/participants: Purposive sample of health professionals managing the palliative care of patients living in the community Results: A total of 15 interviews with health professionals took place. Three meta-themes emerged from the data: (1) uncertainties about integration of PainCheck and changes to current practice, (2) appraisal of current practice and (3) pain management is everybody's responsibility Conclusion: Even the most sceptical of health professionals could see the potential benefits of implementing an electronic patient-reported pain monitoring system. Health professionals have reservations about how PainCheck would work in practice. For optimal use, PainCheck needs embedding within existing electronic health records. Electronic pain monitoring systems have the potential to enable professionals to support patients' pain management more effectively but only when barriers to implementation are appropriately identified and addressed.

  17. Open Dialogues in social networks: professional identity and transdisciplinary collaboration

    Directory of Open Access Journals (Sweden)

    Anne-Lise Holmesland

    2010-09-01

    Full Text Available Aim: The aim of this article is to explore the challenges connected to the transformation and emergence of professional identity in transdisciplinary multi-agency network meetings and the use of Open Dialogue.Introduction: The empirical findings have been taken from a clinical project in southern Norway concerning multi-agency network meetings with persons between 14 and 25 years of age. The project explores how these meetings are perceived by professionals working in various sectors.Methodology: Data was collected through three interviews conducted with two focus groups, the first comprising health care professionals and the second professionals from the social and educational sectors. Content analysis was used to create categories through condensation and interpretation. The two main categories that emerged were 'professional role' and 'teamwork'. These were analysed and compared according to the two first meeting in the two focus groups.Results and discussion: The results indicate different levels of motivation and understanding regarding role transformation processes. The realization of transdisciplinary collaboration is dependent upon the professionals' mutual reliance. The professionals' participation is affected by stereotypes and differences in their sense of belonging to a certain network, and thus their identity transformation seems to be strongly affected. To encourage the use of integrated solutions in mental health care, the professionals' preference for teamwork, the importance of familiarity with each other and knowledge of cultural barriers should be addressed.

  18. Open Dialogues in social networks: professional identity and transdisciplinary collaboration

    Directory of Open Access Journals (Sweden)

    Anne-Lise Holmesland

    2010-09-01

    Full Text Available Aim: The aim of this article is to explore the challenges connected to the transformation and emergence of professional identity in transdisciplinary multi-agency network meetings and the use of Open Dialogue. Introduction: The empirical findings have been taken from a clinical project in southern Norway concerning multi-agency network meetings with persons between 14 and 25 years of age. The project explores how these meetings are perceived by professionals working in various sectors. Methodology: Data was collected through three interviews conducted with two focus groups, the first comprising health care professionals and the second professionals from the social and educational sectors. Content analysis was used to create categories through condensation and interpretation. The two main categories that emerged were 'professional role' and 'teamwork'. These were analysed and compared according to the two first meeting in the two focus groups. Results and discussion: The results indicate different levels of motivation and understanding regarding role transformation processes. The realization of transdisciplinary collaboration is dependent upon the professionals' mutual reliance. The professionals' participation is affected by stereotypes and differences in their sense of belonging to a certain network, and thus their identity transformation seems to be strongly affected. To encourage the use of integrated solutions in mental health care, the professionals' preference for teamwork, the importance of familiarity with each other and knowledge of cultural barriers should be addressed.

  19. Integrated palliative care is about professional networking rather than standardisation of care: A qualitative study with healthcare professionals in 19 integrated palliative care initiatives in five European countries.

    Science.gov (United States)

    den Herder-van der Eerden, Marlieke; van Wijngaarden, Jeroen; Payne, Sheila; Preston, Nancy; Linge-Dahl, Lisa; Radbruch, Lukas; Van Beek, Karen; Menten, Johan; Busa, Csilla; Csikos, Agnes; Vissers, Kris; van Gurp, Jelle; Hasselaar, Jeroen

    2018-06-01

    Integrated palliative care aims at improving coordination of palliative care services around patients' anticipated needs. However, international comparisons of how integrated palliative care is implemented across four key domains of integrated care (content of care, patient flow, information logistics and availability of (human) resources and material) are lacking. To examine how integrated palliative care takes shape in practice across abovementioned key domains within several integrated palliative care initiatives in Europe. Qualitative group interview design. A total of 19 group interviews were conducted (2 in Belgium, 4 in the Netherlands, 4 in the United Kingdom, 4 in Germany and 5 in Hungary) with 142 healthcare professionals from several integrated palliative care initiatives in five European countries. The majority were nurses ( n = 66; 46%) and physicians ( n = 50; 35%). The dominant strategy for fostering integrated palliative care is building core teams of palliative care specialists and extended professional networks based on personal relationships, shared norms, values and mutual trust, rather than developing standardised information exchange and referral pathways. Providing integrated palliative care with healthcare professionals in the wider professional community appears difficult, as a shared proactive multidisciplinary palliative care approach is lacking, and healthcare professionals often do not know palliative care professionals or services. Achieving better palliative care integration into regular healthcare and convincing the wider professional community is a difficult task that will take time and effort. Enhancing standardisation of palliative care into education, referral pathways and guidelines and standardised information exchange may be necessary. External authority (policy makers, insurance companies and professional bodies) may be needed to support integrated palliative care practices across settings.

  20. [Indicators of communication and degree of professional integration in healthcare].

    Science.gov (United States)

    Mola, Ernesto; Maggio, Anna; Vantaggiato, Lucia

    2009-01-01

    According to the chronic care model, improving the management of chronic illness requires efficient communication between health care professionals and the creation of a web of integrated healthcare The aim of this study was to identify an efficient methodology for evaluating the degree of professional integration through indicators related to communication between healthcare professionals. The following types of indicators were identified:-structure indicators to evaluate the presence of prerequisites necessary for implementing the procedures -functional indicators to quantitatively evaluate the use of communications instruments-performance indicators Defining specific indicators may be an appropriate methodology for evaluating the degree of integration and communication between health professionals, available for a bargaining system of incentives.

  1. The importance of dietary change for men diagnosed with and at risk of prostate cancer: a multi-centre interview study with men, their partners and health professionals.

    Science.gov (United States)

    Avery, Kerry N L; Donovan, Jenny L; Horwood, Jeremy; Neal, David E; Hamdy, Freddie C; Parker, Chris; Wade, Julia; Lane, Athene

    2014-05-03

    The diagnosis of prostate cancer (PC) can provide a trigger for dietary change, and there is evidence that healthier diets may improve quality of life and clinical outcomes. However, men's views about dietary change in PC survivorship are largely unknown. This multi-centre qualitative interview study explored men's views about dietary change in PC survivorship, to better understand motivations for, and barriers to, achieving desired changes. The role of radical and active surveillance treatments on dietary change and the influence of men's partners were examined. Focus groups also evaluated stakeholder opinion, including healthcare professionals, about the provision of dietary advice to PC patients. A multi-centre interview study explored views about diet and motivations for, and barriers to, dietary change in men at elevated risk or diagnosed with PC following prostate specific antigen (PSA) testing. 58 men and 11 partners were interviewed. Interviews and focus groups were undertaken with 11 healthcare professionals, 5 patients and 4 partners to evaluate stakeholders' opinions about the feasibility and acceptability of providing dietary advice to PC patients. Data were analysed using methods of constant comparison and thematic analysis. Over half of diagnosed men reported making dietary changes, primarily to promote general or prostate health or facilitate coping, despite their uncertainty about diet-PC links. Interest in dietary advice was high. Information needs varied depending on treatment received, with men on active surveillance more frequently modifying their diet and regarding this as an adjunct therapy. Men considered their partners integral to implementing changes. Provision of dietary advice to men diagnosed with PC was considered by healthcare professionals and men to be feasible and appropriate in the context of a holistic 'care package'. Many men make positive dietary changes after PC diagnosis, which are perceived by men and their partners to bring

  2. Developing a problem-based learning (PBL) curriculum for professionalism and scientific integrity training for biomedical graduate students.

    Science.gov (United States)

    Jones, Nancy L; Peiffer, Ann M; Lambros, Ann; Guthold, Martin; Johnson, A Daniel; Tytell, Michael; Ronca, April E; Eldridge, J Charles

    2010-10-01

    A multidisciplinary faculty committee designed a curriculum to shape biomedical graduate students into researchers with a high commitment to professionalism and social responsibility and to provide students with tools to navigate complex, rapidly evolving academic and societal environments with a strong ethical commitment. The curriculum used problem-based learning (PBL), because it is active and learner-centred and focuses on skill and process development. Two courses were developed: Scientific Professionalism: Scientific Integrity addressed discipline-specific and broad professional norms and obligations for the ethical practice of science and responsible conduct of research (RCR). Scientific Professionalism: Bioethics and Social Responsibility focused on current ethical and bioethical issues within the scientific profession, and implications of research for society. Each small-group session examined case scenarios that included: (1) learning objectives for professional norms and obligations; (2) key ethical issues and philosophies within each topic area; (3) one or more of the RCR instructional areas; and (4) at least one type of moral reflection. Cases emphasised professional standards, obligations and underlying philosophies for the ethical practice of science, competing interests of stakeholders and oversight of science (internal and external). To our knowledge, this is the first use of a longitudinal, multi-semester PBL course to teach scientific integrity and professionalism. Both faculty and students endorsed the active learning approach for these topics, in contrast to a compliance-based approach that emphasises learning rules and regulations.

  3. Planning for Technology Integration in a Professional Learning Community

    Science.gov (United States)

    Thoma, Jennifer; Hutchison, Amy; Johnson, Debra; Johnson, Kurt; Stromer, Elizabeth

    2017-01-01

    Barriers to technology integration in instruction include a lack of time, resources, and professional development. One potential approach to overcoming these barriers is through collaborative work, or professional learning communities. This article focuses on one group of teachers who leveraged their professional learning community to focus on…

  4. Attributes of clinical leadership in contemporary nursing: an integrative review.

    Science.gov (United States)

    Mannix, Judy; Wilkes, Lesley; Daly, John

    2013-08-01

    Effective clinical leadership is offered as the key to healthy, functional and supportive work environments for nurses and other health professionals. However, as a concept it lacks a standard definition and is poorly understood. This paper reports on an integrative review undertaken to uncover current understandings of defining attributes of contemporary clinical leadership in nursing. Data collection involved a search of relevant electronic databases for a 10-year period. Keywords for the search were 'clinical leadership' and 'nursing'. Ten research papers met the inclusion criteria for the integrative review. Analysis of these studies indicated clinical leadership attributes had a clinical focus, a follower/team focus or a personal qualities focus; attributes necessary to sustain supportive workplaces and build the capacity and resilience of nursing workforces. The small number of research-based studies yielded for the review indicates the need for further research in the area of clinical leadership.

  5. Clinical prioritisations of healthcare for the aged--professional roles.

    Science.gov (United States)

    Nortvedt, P; Pedersen, R; Grøthe, K H; Nordhaug, M; Kirkevold, M; Slettebø, A; Brinchmann, B S; Andersen, B

    2008-05-01

    Although fair distribution of healthcare services for older patients is an important challenge, qualitative research exploring clinicians' considerations in clinical prioritisation within this field is scarce. To explore how clinicians understand their professional role in clinical prioritisations in healthcare services for old patients. A semi-structured interview-guide was employed to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis. 20 physicians and 25 nurses working in public hospitals and nursing homes in different parts of Norway. The clinicians struggle with not being able to attend to the comprehensive needs of older patients, and being unfaithful to professional ideals and expectations. There is a tendency towards lowering the standards and narrowing the role of the clinician. This is done in order to secure the vital needs of the patient, but is at the expense of good practice and holistic role modelling. Increased specialisation, advances and increase in medical interventions, economical incentives, organisational structures, and biomedical paradigms, may all contribute to a narrowing of the clinicians' role. Distributing healthcare services in a fair way is generally not described as integral to the clinicians' role in clinical prioritisations. If considerations of justice are not included in clinicians' role, it is likely that others will shape major parts of their roles and responsibilities in clinical prioritisations. Fair distribution of healthcare services for older patients is possible only if clinicians accept responsibility in these questions.

  6. Integration of ICT into Teacher Training and Professional ...

    African Journals Online (AJOL)

    Integration of ICT into Teacher Training and Professional Development in Kenya. ... Makerere Journal of Higher Education ... In Kenya, integration of ICT into the curriculum has been the subject of extensive research and various researches ...

  7. An intrepreneurial innovative role: integration of the clinical nurse specialist and infection prevention professional.

    Science.gov (United States)

    Pintar, Paula A

    2013-01-01

    Hospital quality and financial sustainability rely on reducing healthcare-associated events/infections, length of stay, and readmissions. This project focused on designing an integrated role for the clinical nurse specialist (CNS) and the infection prevention professional (IPP) to proactively manage the delivery of evidence-based practice to high-risk surgical patients. The healthcare industry is in the midst of a paradigm shift driven by changing health policy focusing on quality indicators, patient satisfaction, and lowering costs. Coupled with these indicators is the expectation and responsibility to provide evidence-based practice at all levels of the healthcare continuum. This paradigm shift places healthcare facilities in a very competitive atmosphere as they rally for the revenue of a fixed payer mix. A literature search using CINHAL, PubMed, and the CNS national listserve databases was completed to identify if there was any previously written information available on an integrated role of the CNS/IPP. An online business plan template was used to communicate the significance, implications, and return on organizational investment to practice with establishing this role. Chronic health conditions such as diabetes, hypertension, congestive heart failure, and colonization with multidrug-resistant organisms can place patients at an increased risk for developing a surgical site infection or complications. The CNS/IPP will proactively manage these risk factors, including the patient and family in a preventive care model to manage the acute inpatient high-risk surgical patient. Care management will include coordinated, collaborative, and consultative follow-up by the CNS/IPP in the acute care, long-term care facilities, and home settings. The infection prevention skill set brings a level of clinical expertise that makes a unique CNS. The IPP is immersed in using epidemiological principles that examine the impact of comorbidities and the added risk that can

  8. Integration of the clinical engineering specialist at a high complexity children's hospital. Our professional experience at a surgical center

    International Nuclear Information System (INIS)

    Vargas Enriquez, M J; Chazarreta, B; Emilio, D G; Fernandez Sarda, E

    2007-01-01

    This document aims to find relating points between the current and future Clinical Engineer professional in order to discuss about the hospital environment, its characteristics and its realities which lead to our professional development. The main aim is to depict our experience through a retrospective analysis based on the underwriting experience and consequently to arrive at conclusions that will support the inclusion and active interaction of the Clinic Engineer Specialist as part of a Hospital's Surgical Center

  9. Integration of Multi-Modal Biomedical Data to Predict Cancer Grade and Patient Survival.

    Science.gov (United States)

    Phan, John H; Hoffman, Ryan; Kothari, Sonal; Wu, Po-Yen; Wang, May D

    2016-02-01

    The Big Data era in Biomedical research has resulted in large-cohort data repositories such as The Cancer Genome Atlas (TCGA). These repositories routinely contain hundreds of matched patient samples for genomic, proteomic, imaging, and clinical data modalities, enabling holistic and multi-modal integrative analysis of human disease. Using TCGA renal and ovarian cancer data, we conducted a novel investigation of multi-modal data integration by combining histopathological image and RNA-seq data. We compared the performances of two integrative prediction methods: majority vote and stacked generalization. Results indicate that integration of multiple data modalities improves prediction of cancer grade and outcome. Specifically, stacked generalization, a method that integrates multiple data modalities to produce a single prediction result, outperforms both single-data-modality prediction and majority vote. Moreover, stacked generalization reveals the contribution of each data modality (and specific features within each data modality) to the final prediction result and may provide biological insights to explain prediction performance.

  10. Health promotion as multi-professional and multi-disciplinary work

    Directory of Open Access Journals (Sweden)

    Chrisanthy Sotiriadou

    2010-01-01

    Full Text Available Background: A health promoter is the name given to all those experts who are intended to prevent disease andill health and to increase well-being at the community level. That seems to be a very good and useful idea ingeneral, but can it be achieved by individuals alone?Objective: Review to what extend team work and the concept of team development are a pre-requisite foreffective health promotion. That is the central objective of this article and the answer will be explored through ananalysis of the international literature.Discussion: The first part will set out to define the notions of both health promotion and health promotionspecialists, in order to provide a framework for the multi-professional and multi-disciplinary nature of healthpromotion. The second part will try to establish the meaning of collaboration for health promotion, starting withdefinitions of the concepts: group, team and teamwork. The benefits of collaborative work in health promotionwill be discussed alongside the common barriers that can arise during the process.Conclusions: The article will conclude by proposing the characteristics of a successful team-working healthpromotion group.

  11. MiDas: automatic extraction of a common domain of discourse in sleep medicine for multi-center data integration.

    Science.gov (United States)

    Sahoo, Satya S; Ogbuji, Chimezie; Luo, Lingyun; Dong, Xiao; Cui, Licong; Redline, Susan S; Zhang, Guo-Qiang

    2011-01-01

    Clinical studies often use data dictionaries with controlled sets of terms to facilitate data collection, limited interoperability and sharing at a local site. Multi-center retrospective clinical studies require that these data dictionaries, originating from individual participating centers, be harmonized in preparation for the integration of the corresponding clinical research data. Domain ontologies are often used to facilitate multi-center data integration by modeling terms from data dictionaries in a logic-based language, but interoperability among domain ontologies (using automated techniques) is an unresolved issue. Although many upper-level reference ontologies have been proposed to address this challenge, our experience in integrating multi-center sleep medicine data highlights the need for an upper level ontology that models a common set of terms at multiple-levels of abstraction, which is not covered by the existing upper-level ontologies. We introduce a methodology underpinned by a Minimal Domain of Discourse (MiDas) algorithm to automatically extract a minimal common domain of discourse (upper-domain ontology) from an existing domain ontology. Using the Multi-Modality, Multi-Resource Environment for Physiological and Clinical Research (Physio-MIMI) multi-center project in sleep medicine as a use case, we demonstrate the use of MiDas in extracting a minimal domain of discourse for sleep medicine, from Physio-MIMI's Sleep Domain Ontology (SDO). We then extend the resulting domain of discourse with terms from the data dictionary of the Sleep Heart and Health Study (SHHS) to validate MiDas. To illustrate the wider applicability of MiDas, we automatically extract the respective domains of discourse from 6 sample domain ontologies from the National Center for Biomedical Ontologies (NCBO) and the OBO Foundry.

  12. Email for clinical communication between healthcare professionals.

    Science.gov (United States)

    Goyder, Clare; Atherton, Helen; Car, Mate; Heneghan, Carl J; Car, Josip

    2015-02-20

    Email is one of the most widely used methods of communication, but its use in healthcare is still uncommon. Where email communication has been utilised in health care, its purposes have included clinical communication between healthcare professionals, but the effects of using email in this way are not well known. We updated a 2012 review of the use of email for two-way clinical communication between healthcare professionals. To assess the effects of email for clinical communication between healthcare professionals on healthcare professional outcomes, patient outcomes, health service performance, and service efficiency and acceptability, when compared to other forms of communicating clinical information. We searched: the Cochrane Consumers and Communication Review Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 9 2013), MEDLINE (OvidSP) (1946 to August 2013), EMBASE (OvidSP) (1974 to August 2013), PsycINFO (1967 to August 2013), CINAHL (EbscoHOST) (1982 to August 2013), and ERIC (CSA) (1965 to January 2010). We searched grey literature: theses/dissertation repositories, trials registers and Google Scholar (searched November 2013). We used additional search methods: examining reference lists and contacting authors. Randomised controlled trials, quasi-randomised trials, controlled before and after studies, and interrupted time series studies examining interventions in which healthcare professionals used email for communicating clinical information in the form of: 1) unsecured email, 2) secure email, or 3) web messaging. All healthcare professionals, patients and caregivers in all settings were considered. Two authors independently assessed studies for inclusion, assessed the included studies' risk of bias, and extracted data. We contacted study authors for additional information and have reported all measures as per the study report. The previous version of this review included one randomised controlled

  13. Organizational impact of nurse supply and workload on nurses continuing professional development opportunities: an integrative review.

    Science.gov (United States)

    Coventry, Tracey H; Maslin-Prothero, Sian E; Smith, Gilly

    2015-12-01

    To identify the best evidence on the impact of healthcare organizations' supply of nurses and nursing workload on the continuing professional development opportunities of Registered Nurses in the acute care hospital. To maintain registration and professional competence nurses are expected to participate in continuing professional development. One challenge of recruitment and retention is the Registered Nurse's ability to participate in continuing professional development opportunities. The integrative review method was used to present Registered Nurses perspectives on this area of professional concern. The review was conducted for the period of 2001-February 2015. Keywords were: nurs*, continuing professional development, continuing education, professional development, supply, shortage, staffing, workload, nurse: patient ratio, barrier and deterrent. The integrative review used a structured approach for literature search and data evaluation, analysis and presentation. Eleven international studies met the inclusion criteria. Nurses are reluctant or prevented from leaving clinical settings to attend continuing professional development due to lack of relief cover, obtaining paid or unpaid study leave, use of personal time to undertake mandatory training and organizational culture and leadership issues constraining the implementation of learning to benefit patients. Culture, leadership and workload issues impact nurses' ability to attend continuing professional development. The consequences affect competence to practice, the provision of safe, quality patient care, maintenance of professional registration, job satisfaction, recruitment and retention. Organizational leadership plays an important role in supporting attendance at continuing professional development as an investment for the future. © 2015 John Wiley & Sons Ltd.

  14. Assessment of radiation damage - the need for a multi-parametric and integrative approach with the help of both clinical and biological dosimetry

    International Nuclear Information System (INIS)

    Meineke, Viktor

    2008-01-01

    provide the best basis for triage and planning and providing of medical treatment after accidental radiation exposure always different and independent diagnostic procedures integrating all clinical aspects as well as different biological indicators have to be applied. Up to now this multi parametric approach is missing in medical radiation accident management. A new integrative concept is shown and discussed. (author)

  15. Clinical criminology: a bridge between forensic professionals.

    Science.gov (United States)

    Silfen, P; Ben-David, S

    1993-01-01

    In recent decades a new profession has developed--clinical criminology. The purpose of this article is to highlight its development. Criminology is defined as a interdisciplinary super-profession. We tend to view criminology as a basic profession with a number of specializations. Clinical criminology is one of these specializations. Forensic psychiatry and clinical criminology have common roots in psychiatry, law and behavioural sciences. They overlap in some fields. Members of both professions work in the same setting and share some of the tasks, but the formal and professional responsibilities differ significantly. We perceive clinical criminology and forensic psychiatry as complementary professions belonging to medicine. The multidisciplinary educated clinical criminologist is the only professional in the forensic system who is qualified to moderate between the mental health and legal expert.

  16. Integrable multi parametric SU(N) chain

    International Nuclear Information System (INIS)

    Foerster, Angela; Roditi, Itzhak; Rodrigues, Ligia M.C.S.

    1996-03-01

    We analyse integrable models associated to a multi parametric SU(N) R-matrix. We show that the Hamiltonians describe SU(N) chains with twisted boundary conditions and that the underlying algebraic structure is the multi parametric deformation of SU(N) enlarged by the introduction of a central element. (author). 15 refs

  17. Professional identity and role transitions in clinical managers.

    Science.gov (United States)

    Spehar, Ivan; Frich, Jan C; Kjekshus, Lars Erik

    2015-01-01

    The purpose of this paper is to investigate how clinicians' professional background influences their transition into the managerial role and identity as clinical managers. The authors interviewed and observed 30 clinicians in managerial positions in Norwegian hospitals. A central finding was that doctors experienced difficulties in reconciling the role as health professional with the role as manager. They maintained a health professional identity and reported to find meaning and satisfaction from clinical work. Doctors also emphasized clinical work as a way of gaining legitimacy and respect from medical colleagues. Nurses recounted a faster and more positive transition into the manager role, and were more fully engaged in the managerial aspects of the role. The authors advance that health care organizations need to focus on role, identity and need satisfaction when recruiting and developing clinicians to become clinical managers. The study suggests that the inclusion of aspects from identity and need satisfaction literature expands on and enriches the study of clinical managers.

  18. Integrated web-based viewing and secure remote access to a clinical data repository and diverse clinical systems.

    Science.gov (United States)

    Duncan, R G; Saperia, D; Dulbandzhyan, R; Shabot, M M; Polaschek, J X; Jones, D T

    2001-01-01

    The advent of the World-Wide-Web protocols and client-server technology has made it easy to build low-cost, user-friendly, platform-independent graphical user interfaces to health information systems and to integrate the presentation of data from multiple systems. The authors describe a Web interface for a clinical data repository (CDR) that was moved from concept to production status in less than six months using a rapid prototyping approach, multi-disciplinary development team, and off-the-shelf hardware and software. The system has since been expanded to provide an integrated display of clinical data from nearly 20 disparate information systems.

  19. A discourse on the integration of library and information science educational program with professional practicum——The case of NSL

    Institute of Scientific and Technical Information of China (English)

    CHU Jingli

    2008-01-01

    There is an ongoing professional tensionin the LIS community about the structural relationship between LIS education and professional practice in terms of the best way in fostering and strengthening the education program for librarianship.This is increasingly becoming an urgent issue due to the pressing demands of a rapidly changing information environment.The divergent viewpoints and approaches of these two professional bodies toward one of the most important issues of their common interest are further aggravated by each of their own entrenched professional provincialism as well as by their isolated professional undertakings.These factors are inevitably threatening the vitality and thriving of both bodies.In an attempt to ease this developing trend of professional tension from evolving further into a mutually self-destructive situation,it is suggested in this paper that librarians and library educators should join hands together and transcend their own provincial interest by solving this thorny issue of this professional tension which has multi-dimensional adverse impacts on both professional enterprises.The collaboration of these two parties can serve as a catalyst to bring the two professional groups together more closely and in an organic way to reconstruct a sound LIS educational program with an integral component of professional practicum such as the case of National Science Library,the Chinese Academy of Sciences (CAS).The author believes that the integration of LIS education with professional practicum being offered at National Science Library of CAS (NSL) may shed light onto a new vista of hope for those who are so dedicated themselves to the changes of the LIS education.

  20. A discourse on the integration of library and information science educational program with professional practicum——The case of NSL

    Institute of Scientific and Technical Information of China (English)

    CHU; Jingli

    2008-01-01

    There is an ongoing professional tension in the LIS community about the structural relationship between LIS education and professional practice in terms of the best way in fostering and strengthening the education program for librarianship.This is increasingly becoming an urgent issue due to the pressing demands of a rapidly changing information environment.The divergent viewpoints and approaches of these two professional bodies toward one of the most important issues of their common interest are further aggravated by each of their own entrenched professional provincialism as well as by their isolated professional undertakings.These factors are inevitably threatening the vitality and thriving of both bodies.In an attempt to ease this developing trend of professional tension from evolving further into a mutually self-destructive situation,it is suggested in this paper that librarians and library educators should join hands together and transcend their own provincial interest by solving this thorny issue of this professional tension which has multi-dimensional adverse impacts on both professional enterprises.The collaboration of these two parties can serve as a catalyst to bring the two professional groups together more closely and in an organic way to reconstruct a sound LIS educational program with an integral component of professional practicum such as the case of National Science Library,the Chinese Academy of Sciences(CAS).The author believes that the integration of LIS education with professional practicum being offered at National Science Library of CAS(NSL)may shed light onto a new vista of hope for those who are so dedicated themselves to the changes of the LIS education.

  1. Integrating Professional Development across the Curriculum: An Effectiveness Study

    Science.gov (United States)

    Ciarocco, Natalie J.; Dinella, Lisa M.; Hatchard, Christine J.; Valosin, Jayde

    2016-01-01

    The current study empirically tested the effectiveness of a modular approach to integrating professional development across an undergraduate psychology curriculum. Researchers conducted a two-group, between-subjects experiment on 269 undergraduate psychology students assessing perceptions of professional preparedness and learning. Analysis…

  2. A review on machine learning principles for multi-view biological data integration.

    Science.gov (United States)

    Li, Yifeng; Wu, Fang-Xiang; Ngom, Alioune

    2018-03-01

    Driven by high-throughput sequencing techniques, modern genomic and clinical studies are in a strong need of integrative machine learning models for better use of vast volumes of heterogeneous information in the deep understanding of biological systems and the development of predictive models. How data from multiple sources (called multi-view data) are incorporated in a learning system is a key step for successful analysis. In this article, we provide a comprehensive review on omics and clinical data integration techniques, from a machine learning perspective, for various analyses such as prediction, clustering, dimension reduction and association. We shall show that Bayesian models are able to use prior information and model measurements with various distributions; tree-based methods can either build a tree with all features or collectively make a final decision based on trees learned from each view; kernel methods fuse the similarity matrices learned from individual views together for a final similarity matrix or learning model; network-based fusion methods are capable of inferring direct and indirect associations in a heterogeneous network; matrix factorization models have potential to learn interactions among features from different views; and a range of deep neural networks can be integrated in multi-modal learning for capturing the complex mechanism of biological systems.

  3. Rethinking clinical governance : Healthcare professionals' views: a Delphi study

    NARCIS (Netherlands)

    Veenstra, Gepke L.; Ahaus, Kees; Welker, Gera A.; Heineman, Erik; van der Laan, Maarten J.; Muntinghe, Friso L. H.

    OBJECTIVE: Although the guiding principle of clinical governance states that healthcare professionals are the leading contributors to quality and safety in healthcare, little is known about what healthcare professionals perceive as important for clinical governance. The aim of this study is to

  4. Professional formation through personal involvement and value integration.

    Science.gov (United States)

    Haugland, Britt Øvrebø; Lassen, Rasmus M; Giske, Tove

    2018-03-01

    Formation is an important part of nursing education, and it is the responsibility of nurse educators to facilitate learning situations that provide students with opportunities for personal discovery. Studies have shown that awareness of one's own vulnerability can be a source of professional maturation and courageous action. The study setting is a Christian university that emphasises its value base through the perspective of diakonia in the nursing programme. Diakonia is understood as the provision of caring. Two hundred and forty-five pages of reflective journals from 124 third-year students were analysed with qualitative content analysis. The main theme of the study was Professional formation through personal involvement and value integration. Four categories emerged: 1) Diakonia as a guide to professional compassion; 2) Consciousness of one's own values; 3) The urge to act courageously; and 4) Choosing to spend the time available. The article discusses how students can integrate values in their professional lives by using all senses when learning in real-life situations and by using systematic reflection alone and together with others. Professional formation is an ongoing process, and we have found that mandatory participation, reiteration and progression are important conditions for such formation to occur. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Towards Integrating the Principlist and Casuist Approaches to Ethical Decisions via Multi-Criterial Support

    DEFF Research Database (Denmark)

    Kaltoft, Mette Kjer; Nielsen, Jesper Bo; Salkeld, Glenn

    2016-01-01

    of each option, as a contribution to enhanced deliberation. As proof of concept and method an exemplar aid adds veracity and confidentiality to beneficence, non-maleficence, autonomy and justice, as the criteria, with case-based reasoning supplying the necessary inputs for the decision of whether a nurse......An interactive decision support tool based on Multi-Criteria Decision Analysis (MCDA) can help health professionals integrate the principlist (principle-based) and casuist (case-based) approaches to ethical decision making in both their training and practice. MCDA can incorporate generic ethical...

  6. Multi-disciplinary coupling for integrated design of propulsion systems

    Science.gov (United States)

    Chamis, C. C.; Singhal, S. N.

    1993-01-01

    Effective computational simulation procedures are described for modeling the inherent multi-disciplinary interactions for determining the true response of propulsion systems. Results are presented for propulsion system responses including multi-discipline coupling effects via (1) coupled multi-discipline tailoring, (2) an integrated system of multidisciplinary simulators, (3) coupled material-behavior/fabrication-process tailoring, (4) sensitivities using a probabilistic simulator, and (5) coupled materials/structures/fracture/probabilistic behavior simulator. The results show that the best designs can be determined if the analysis/tailoring methods account for the multi-disciplinary coupling effects. The coupling across disciplines can be used to develop an integrated interactive multi-discipline numerical propulsion system simulator.

  7. Integrating Behavioral Health and Primary Care: Consulting, Coordinating and Collaborating Among Professionals.

    Science.gov (United States)

    Cohen, Deborah J; Davis, Melinda; Balasubramanian, Bijal A; Gunn, Rose; Hall, Jennifer; deGruy, Frank V; Peek, C J; Green, Larry A; Stange, Kurt C; Pallares, Carla; Levy, Sheldon; Pollack, David; Miller, Benjamin F

    2015-01-01

    This paper sought to describe how clinicians from different backgrounds interact to deliver integrated behavioral and primary health care, and the contextual factors that shape such interactions. This was a comparative case study in which a multidisciplinary team used an immersion-crystallization approach to analyze data from observations of practice operations, interviews with practice members, and implementation diaries. The observed practices were drawn from 2 studies: Advancing Care Together, a demonstration project of 11 practices located in Colorado; and the Integration Workforce Study, consisting of 8 practices located across the United States. Primary care and behavioral health clinicians used 3 interpersonal strategies to work together in integrated settings: consulting, coordinating, and collaborating (3Cs). Consulting occurred when clinicians sought advice, validated care plans, or corroborated perceptions of a patient's needs with another professional. Coordinating involved 2 professionals working in a parallel or in a back-and-forth fashion to achieve a common patient care goal, while delivering care separately. Collaborating involved 2 or more professionals interacting in real time to discuss a patient's presenting symptoms, describe their views on treatment, and jointly develop a care plan. Collaborative behavior emerged when a patient's care or situation was complex or novel. We identified contextual factors shaping use of the 3Cs, including: time to plan patient care, staffing, employing brief therapeutic approaches, proximity of clinical team members, and electronic health record documenting behavior. Primary care and behavioral health clinicians, through their interactions, consult, coordinate, and collaborate with each other to solve patients' problems. Organizations can create integrated care environments that support these collaborations and health professions training programs should equip clinicians to execute all 3Cs routinely in practice

  8. Survivable integrated grooming in multi-granularity optical networks

    Science.gov (United States)

    Wu, Jingjing; Guo, Lei; Wei, Xuetao; Liu, Yejun

    2012-05-01

    Survivability is an important issue to ensure the service continuity in optical network. At the same time, with the granularity of traffic demands ranging from sub-wavelength-level to wavelength-level, traffic demands need to be aggregated and carried over the network in order to utilize resources effectively. Therefore, multi-granularity grooming is proposed to save the cost and reduce the number of switching ports in Optical-Cross Connects (OXCs). However, current works mostly addressed the survivable wavelength or waveband grooming. Therefore, in this paper, we propose three heuristic algorithms called Multi-granularity Dedicated Protection Grooming (MDPG), Multi-granularity Shared Protection Grooming (MSPG) and Multi-granularity Mixed Protection Grooming (MMPG), respectively. All of them are performed based on the Survivable Multi-granularity Integrated Auxiliary Graph (SMIAG) that includes one Wavelength Integrated Auxiliary Graph (WIAG) for wavelength protection and one waveBand Integrated Auxiliary Graph (BIAG) for waveband protection. Numerical results show that MMPG has the lowest average port-cost, the best resource utilization ratio and the lowest blocking probability among these three algorithms. Compared with MDPG, MSPG has lower average port-cost, better resource utilization ratio and lower blocking probability.

  9. MEDCIS: Multi-Modality Epilepsy Data Capture and Integration System.

    Science.gov (United States)

    Zhang, Guo-Qiang; Cui, Licong; Lhatoo, Samden; Schuele, Stephan U; Sahoo, Satya S

    2014-01-01

    Sudden Unexpected Death in Epilepsy (SUDEP) is the leading mode of epilepsy-related death and is most common in patients with intractable, frequent, and continuing seizures. A statistically significant cohort of patients for SUDEP study requires meticulous, prospective follow up of a large population that is at an elevated risk, best represented by the Epilepsy Monitoring Unit (EMU) patient population. Multiple EMUs need to collaborate, share data for building a larger cohort of potential SUDEP patient using a state-of-the-art informatics infrastructure. To address the challenges of data integration and data access from multiple EMUs, we developed the Multi-Modality Epilepsy Data Capture and Integration System (MEDCIS) that combines retrospective clinical free text processing using NLP, prospective structured data capture using an ontology-driven interface, interfaces for cohort search and signal visualization, all in a single integrated environment. A dedicated Epilepsy and Seizure Ontology (EpSO) has been used to streamline the user interfaces, enhance its usability, and enable mappings across distributed databases so that federated queries can be executed. MEDCIS contained 936 patient data sets from the EMUs of University Hospitals Case Medical Center (UH CMC) in Cleveland and Northwestern Memorial Hospital (NMH) in Chicago. Patients from UH CMC and NMH were stored in different databases and then federated through MEDCIS using EpSO and our mapping module. More than 77GB of multi-modal signal data were processed using the Cloudwave pipeline and made available for rendering through the web-interface. About 74% of the 40 open clinical questions of interest were answerable accurately using the EpSO-driven VISual AGregagator and Explorer (VISAGE) interface. Questions not directly answerable were either due to their inherent computational complexity, the unavailability of primary information, or the scope of concept that has been formulated in the existing Ep

  10. Implementation of the concept of home hospitalisation for heart patients by means of telehomecare technology: integration of clinical tasks

    Directory of Open Access Journals (Sweden)

    Birthe Dinesen

    2007-05-01

    Full Text Available Purpose: To explore how the implementation of the concept ‘Home hospitalisation of heart patients’ by means of telehomecare technology influences the integration of clinical tasks across healthcare sectors. Theory: Inter-organisational theory. Methods: The case study approach was applied. Triangulations of data collection techniques were used: documentary materials, participant observation, qualitative and focus group interviews. Results: The clinical decision-making and task solving became multidisciplinary and integrated with the implementation of telehomecare and, therefore, complex in terms of the prescription and adjustment of patient medicine. Workflows between healthcare professionals across sectors changed from sequential to collective client flows. Pre-existing procedures for patient care, treatment, and responsibility were challenged. In addition, the number of tasks for the district nurses increased. Integration in the clinical task-solving area increases fragmentation in the knowledge technologies in a network perspective. Conclusions: Implementing the concept of ‘Home hospitalisation of heart patients’ by means of telehomecare technology will result in a more integrated clinical task-solving process that involves healthcare professionals from various sectors. Overall, the integration of clinical tasks between hospital and district nursing will result in a direct benefit for the heart patients.

  11. [HOLOCAUST DOCTORS SURVIVORS IN ISRAEL 1945-1952: FROM EARLY POSITIONS TO PROFESSIONAL INTEGRATION].

    Science.gov (United States)

    Herzog, Rachel

    2017-04-01

    The encounter between Holocaust doctor survivors and the Israeli society was part of the whole encounter between Holocaust survivors and the Israeli society. The present thesis aimed at evaluating the integration process of Holocaust doctor survivors in the Israeli health care system from 1945 until the end of 1952. Between these years about 1350 doctors arrived in Israel, the vast majority of them Holocaust survivors. Their rapid entrance to work provided the healthcare system with professional manpower, contributing their share during a tough period of the nation's history. The doctors themselves gained the opportunity for rapid professional recovery and social integration, all at the same time. The individual contributions of each of these doctors constitute a significant collective contribution. It is an inspiring story of personal and universal human victory. There are similarities between the absorption of all Holocaust survivals in Israel with regard to the motives of immigration and the feelings towards the absorption places and organizations. But Holocaust doctor survivors didn't stay too long and moved out rather quickly. The beginning was difficult. They were absorbed in each of the healthcare fronts, but especially in new clinics established in immigrant-concentrated areas, in hospitals dedicated to lung diseases and in psychiatric hospitals. They started at low professional levels, but as soon as 1952, they could be found in management positions. This was indicative of their professional advancement and the willingness of the medical establishment to absorb and promote.

  12. Enabling professional development in mental health nursing: the role of clinical leadership.

    Science.gov (United States)

    Ennis, G; Happell, B; Reid-Searl, K

    2015-10-01

    Clinical leadership is acknowledged as important to the nursing profession. While studies continue to identify its significance in contributing to positive outcomes for consumers, the role that clinical leadership has in enabling and supporting professional development in mental health nursing is poorly understood. This study utilized a grounded theory methodology to explore the characteristics clinicians consider important for clinical leadership and its significance for mental health nursing in day-to-day clinical practice. Individual face-to-face, semi-structured interviews were conducted with nurses working in mental health settings. Participants described the important role that clinical leaders play in enabling professional development of others through role modelling and clinical teaching. They describe how nurses, whom they perceive as clinical leaders, use role modelling and clinical teaching to influence the professional development of nursing staff and undergraduate nursing students. Attributes such as professionalism and honesty were seen, by participants, as enablers for clinical leaders in effectively and positively supporting the professional development of junior staff and undergraduate nurses in mental health nursing. This paper examines clinical leadership from the perspective of mental health nurses delivering care, and highlights the important role of clinical leaders in supporting professional development in mental health nursing. © 2015 John Wiley & Sons Ltd.

  13. Integration of the clinical engineering specialist at a high complexity children's hospital. Our professional experience at a surgical center

    Energy Technology Data Exchange (ETDEWEB)

    Vargas Enriquez, M J; Chazarreta, B; Emilio, D G; Fernandez Sarda, E [Surgical Center-Neurophysiology Division of Medical Tecnology Department, Garrahan Children' s Hospital, Combate de los Pozos 1881, Buenos Aires (Argentina)

    2007-11-15

    This document aims to find relating points between the current and future Clinical Engineer professional in order to discuss about the hospital environment, its characteristics and its realities which lead to our professional development. The main aim is to depict our experience through a retrospective analysis based on the underwriting experience and consequently to arrive at conclusions that will support the inclusion and active interaction of the Clinic Engineer Specialist as part of a Hospital's Surgical Center.

  14. 4 pitfalls to clinical integration.

    Science.gov (United States)

    Redding, John

    2012-11-01

    Four common mistakes can easily thwart clinical integration: Assuming that EHR adoption is the cornerstone of successful integration; Delaying the development of ambulatory services that support clinical integration; Believing that knowledge of clinical integration initiatives will passively diffuse through the ranks; Attaching too much weight to Federal Trade Commission/Department of Justice approval of a clinical integration model.

  15. Emergency Medicine Resident Perceptions of Medical Professionalism.

    Science.gov (United States)

    Jauregui, Joshua; Gatewood, Medley O; Ilgen, Jonathan S; Schaninger, Caitlin; Strote, Jared

    2016-05-01

    Medical professionalism is a core competency for emergency medicine (EM) trainees; but defining professionalism remains challenging, leading to difficulties creating objectives and performing assessment. Because professionalism is dynamic, culture-specific, and often taught by modeling, an exploration of trainees' perceptions can highlight their educational baseline and elucidate the importance they place on general conventional professionalism domains. To this end, our objective was to assess the relative value EM residents place on traditional components of professionalism. We performed a cross-sectional, multi-institutional survey of incoming and graduating EM residents at four programs. The survey was developed using the American Board of Internal Medicine's "Project Professionalism" and the Accreditation Council of Graduate Medical Education definition of professionalism competency. We identified 27 attributes within seven domains: clinical excellence, humanism, accountability, altruism, duty and service, honor and integrity, and respect for others. Residents were asked to rate each attribute on a 10-point scale. We analyzed data to assess variance across attributes as well as differences between residents at different training levels or different institutions. Of the 114 residents eligible, 100 (88%) completed the survey. The relative value assigned to different professional attributes varied considerably, with those in the altruism domain valued significantly lower and those in the "respect for others" and "honor and integrity" valued significantly higher (p<0.001). Significant differences were found between interns and seniors for five attributes primarily in the "duty and service" domain (p<0.05). Among different residencies, significant differences were found with attributes within the "altruism" and "duty and service" domains (p<0.05). Residents perceive differences in the relative importance of traditionally defined professional attributes and this may

  16. Assessing the Value of Moving More-The Integral Role of Qualified Health Professionals.

    Science.gov (United States)

    Arena, Ross; McNeil, Amy; Lavie, Carl J; Ozemek, Cemal; Forman, Daniel; Myers, Jonathan; Laddu, Deepika R; Popovic, Dejana; Rouleau, Codie R; Campbell, Tavis S; Hills, Andrew P

    2018-04-01

    Being physically active or, in a broader sense, simply moving more throughout each day is one of the most important components of an individual's health plan. In conjunction with regular exercise training, taking more steps in a day and sitting less are also important components of one's movement portfolio. Given this priority, health care professionals must develop enhanced skills for prescribing and guiding individualized movement programs for all their patients. An important component of a health care professional's ability to prescribe movement as medicine is competency in assessing an individual's risk for untoward events if physical exertion was increased. The ability to appropriately assess one's risk before advising an individual to move more is integral to clinical decision-making related to subsequent testing if needed, exercise prescription, and level of supervision with exercise training. At present, there is a lack of clarity pertaining to how a health care professional should go about assessing an individual's readiness to move more on a daily basis in a safe manner. Therefore, this perspectives article clarifies key issues related to prescribing movement as medicine and presents a new process for clinical assessment before prescribing an individualized movement program. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. AGU's Updated Scientific Integrity and Professional Ethics Policy

    Science.gov (United States)

    McPhaden, M. J.

    2017-12-01

    AGU'S mission is to promote discovery in Earth and space science for the benefit of humanity. This mission can only be accomplished if all those engaged in the scientific enterprise uphold the highest standards of scientific integrity and professional ethics. AGU's Scientific Integrity and Professional Ethics Policy provides a set of principles and guidelines for AGU members, staff, volunteers, contractors, and non-members participating in AGU sponsored programs and activities. The policy has recently been updated to include a new code of conduct that broadens the definition of scientific misconduct to include discrimination, harassment, and bullying. This presentation provides the context for what motivated the updated policy, an outline of the policy itself, and a discussion of how it is being communicated and applied.

  18. Multi-disciplinary coupling effects for integrated design of propulsion systems

    Science.gov (United States)

    Chamis, C. C.; Singhal, S. N.

    1993-01-01

    Effective computational simulation procedures are described for modeling the inherent multi-disciplinary interactions which govern the accurate response of propulsion systems. Results are presented for propulsion system responses including multi-disciplinary coupling effects using coupled multi-discipline thermal, structural, and acoustic tailoring; an integrated system of multi-disciplinary simulators; coupled material behavior/fabrication process tailoring; sensitivities using a probabilistic simulator; and coupled materials, structures, fracture, and probabilistic behavior simulator. The results demonstrate that superior designs can be achieved if the analysis/tailoring methods account for the multi-disciplinary coupling effects. The coupling across disciplines can be used to develop an integrated coupled multi-discipline numerical propulsion system simulator.

  19. Multi combined Adlerian supervision in Counseling

    OpenAIRE

    Gungor, Abdi

    2017-01-01

    For counselor professional and counselor education, supervision is an important process, in which more experienced professional helps and guides less experienced professional. To provide an effective and beneficial supervision, various therapy, development, or process based approaches and models have been developed. In addition, different eclectic models integrating more than one model have been developed. In this paper, as a supervision model, multi combined Adlerian supervision model is pro...

  20. Self-assessment of professionalism in physical therapy education.

    Science.gov (United States)

    Anderson, Deborah K; Irwin, Kent E

    2013-01-01

    With the physical therapy (PT) professions' advancement to the clinical doctorate degree and the promotion of autonomous practice, exemplary professional conduct is an expectation of the PT profession. PT education programs are being challenged to develop methods to teach and assess professional behavior. Forty-three PT students (11 male and 32 female, ages 20-28 years) completed the APTA Professionalism in Physical Therapy: Core Values Self-Assessment (PPTCVSA) after their first 3 week clinical experience and again after their final clinical experience. A mixed design ANOVA compared participants' total scores and individual Core Value scores on the Professionalism in Physical Therapy: Core Values Self-Assessment (PPTCVSA) after 3 and 33 weeks of clinical education. The effects of gender, age, and undergraduate area of study on growth in professionalism scores were also investigated. Total PPTCVSA scores and individual Core Value scores on professionalism (accountability, altruism, compassion/caring, excellence, integrity, professional duty, and social responsibility) were higher after 33 weeks compared to scores after 3 weeks of clinical education. Female student's total professionalism scores were higher than male student's scores on both the first and second self-assessments. In addition, female students scored themselves higher than their male peers on accountability, excellence, integrity, and professional duty. Improved scores on the PPTCVSA indicate that physical therapy education is playing an important role in the development of professional behavior, knowledge, and application in practice.

  1. Research Integrity and Research Ethics in Professional Codes of Ethics: Survey of Terminology Used by Professional Organizations across Research Disciplines

    Science.gov (United States)

    Komić, Dubravka; Marušić, Stjepan Ljudevit; Marušić, Ana

    2015-01-01

    Professional codes of ethics are social contracts among members of a professional group, which aim to instigate, encourage and nurture ethical behaviour and prevent professional misconduct, including research and publication. Despite the existence of codes of ethics, research misconduct remains a serious problem. A survey of codes of ethics from 795 professional organizations from the Illinois Institute of Technology’s Codes of Ethics Collection showed that 182 of them (23%) used research integrity and research ethics terminology in their codes, with differences across disciplines: while the terminology was common in professional organizations in social sciences (82%), mental health (71%), sciences (61%), other organizations had no statements (construction trades, fraternal social organizations, real estate) or a few of them (management, media, engineering). A subsample of 158 professional organizations we judged to be directly involved in research significantly more often had statements on research integrity/ethics terminology than the whole sample: an average of 10.4% of organizations with a statement (95% CI = 10.4-23-5%) on any of the 27 research integrity/ethics terms compared to 3.3% (95% CI = 2.1–4.6%), respectively (Pethics concepts used prescriptive language in describing the standard of practice. Professional organizations should define research integrity and research ethics issues in their ethics codes and collaborate within and across disciplines to adequately address responsible conduct of research and meet contemporary needs of their communities. PMID:26192805

  2. Arts Integration as Potentiality for Professional Development for Teachers

    DEFF Research Database (Denmark)

    Jensen, Julie Borup; McCandless, Peggy

    2013-01-01

    This paper investigates the potentialities for professional development, when teachers work with integration of arts and academic subjects in the classroom. The idea of integrating arts and academic subjects can be seen as a way of experimenting with teaching. Experiments in the classroom as a wa...

  3. Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the design and operation of multi-center clinical trials: a qualitative research study.

    Science.gov (United States)

    Eisenstein, Eric L; Diener, Lawrence W; Nahm, Meredith; Weinfurt, Kevin P

    2011-12-01

    New technologies may be required to integrate the National Institutes of Health's Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators fell into two categories: acceptance by key regulators and the scientific community, and usability for researchers and clinicians. Issues reported by the coordinating center, participating sites, and study subjects were those faced when integrating new technologies into existing clinical trial systems. We then defined elements of a PROMIS Tool Kit required for integrating PROMIS into a multi-center clinical trial environment. The requirements identified in this study serve as a framework for future investigators in the design, development, implementation, and operation of PROMIS Tool Kit technologies.

  4. Professional Quality of Life and Clinical Competencies among Korean Nurses

    Directory of Open Access Journals (Sweden)

    Kyunghee Kim, PhD

    2015-09-01

    Conclusions: This study demonstrated that it is possible to directly examine the relationship between professional quality of life level and clinical competence among nurses. Thus, interventions to increase nurses' compassion satisfaction and relieve compassion fatigue are needed, as professional quality of life may affect clinical competence.

  5. Research Integrity and Research Ethics in Professional Codes of Ethics: Survey of Terminology Used by Professional Organizations across Research Disciplines.

    Science.gov (United States)

    Komić, Dubravka; Marušić, Stjepan Ljudevit; Marušić, Ana

    2015-01-01

    Professional codes of ethics are social contracts among members of a professional group, which aim to instigate, encourage and nurture ethical behaviour and prevent professional misconduct, including research and publication. Despite the existence of codes of ethics, research misconduct remains a serious problem. A survey of codes of ethics from 795 professional organizations from the Illinois Institute of Technology's Codes of Ethics Collection showed that 182 of them (23%) used research integrity and research ethics terminology in their codes, with differences across disciplines: while the terminology was common in professional organizations in social sciences (82%), mental health (71%), sciences (61%), other organizations had no statements (construction trades, fraternal social organizations, real estate) or a few of them (management, media, engineering). A subsample of 158 professional organizations we judged to be directly involved in research significantly more often had statements on research integrity/ethics terminology than the whole sample: an average of 10.4% of organizations with a statement (95% CI = 10.4-23-5%) on any of the 27 research integrity/ethics terms compared to 3.3% (95% CI = 2.1-4.6%), respectively (Porganizations should define research integrity and research ethics issues in their ethics codes and collaborate within and across disciplines to adequately address responsible conduct of research and meet contemporary needs of their communities.

  6. Knowledge integration, teamwork and performance in health care.

    Science.gov (United States)

    Körner, Mirjam; Lippenberger, Corinna; Becker, Sonja; Reichler, Lars; Müller, Christian; Zimmermann, Linda; Rundel, Manfred; Baumeister, Harald

    2016-01-01

    Knowledge integration is the process of building shared mental models. The integration of the diverse knowledge of the health professions in shared mental models is a precondition for effective teamwork and team performance. As it is known that different groups of health care professionals often tend to work in isolation, the authors compared the perceptions of knowledge integration. It can be expected that based on this isolation, knowledge integration is assessed differently. The purpose of this paper is to test these differences in the perception of knowledge integration between the professional groups and to identify to what extent knowledge integration predicts perceptions of teamwork and team performance and to determine if teamwork has a mediating effect. The study is a multi-center cross-sectional study with a descriptive-explorative design. Data were collected by means of a staff questionnaire for all health care professionals working in the rehabilitation clinics. The results showed that there are significant differences in knowledge integration within interprofessional health care teams. Furthermore, it could be shown that knowledge integration is significantly related to patient-centered teamwork as well as to team performance. Mediation analysis revealed partial mediation of the effect of knowledge integration on team performance through teamwork. PRACTICAL/IMPLICATIONS: In practice, the results of the study provide a valuable starting point for team development interventions. This is the first study that explored knowledge integration in medical rehabilitation teams and its relation to patient-centered teamwork and team performance.

  7. Assessing healthcare professionals' experiences of integrated care: do surveys tell the full story?

    Science.gov (United States)

    Stephenson, Matthew D; Campbell, Jared M; Lisy, Karolina; Aromataris, Edoardo C

    2017-09-01

    routinely being surveyed, including Workload, Clear Leadership/Decision-Making, Management, Flexibility of Integrated Care Model, Engagement, Usefulness of Integrated Care and Collaboration, and Positive Impact/Clinical Benefits/Practice Level Benefits. There were several domains identified from qualitative research that are not routinely included in quantitative surveys to assess health professionals' experiences of integrated care. In addition, the qualitative findings suggest that the experiences of HCPs are often impacted by deeper aspects than those measured by existing surveys. Incorporation of targeted items within these domains in the design of surveys should enhance the capture of data that are relevant to the experiences of HCPs with integrated care, which may assist in more comprehensive evaluation and subsequent improvement of integrated care programs.

  8. Multi-professional holding: A new way of connecting liberal profession in the French legal system

    Directory of Open Access Journals (Sweden)

    Knežić-Popović Dragana

    2015-01-01

    Full Text Available In recent decades, significant changes occur in the exercise of the liberal professions. In particular, the French legislator made a big step forward, after almost fifty years of searching for the optimal solution, anticipating the holding of the liberal professions that establishes the principle of multi-professional connections on the basis of equity investments. The companies for the financial participation of the liberal professions can have a share in the capital assets of companies for performing the liberal professions as well as in business entities of General Corporate Law, and which have as their subject the performance of two or more professions including: attorney-at-law, notaries, bailiffs, court appraisers, accountants, auditors and advisers for industrial property. In other words, this is to allow the establishment of a holding company whose branches conduct their regulated profession in these domains. The aim was to create a network of companies from different professions in law, accounting and industrial property, whose connective tissue is the capital, and thereby strengthen their global competitive ability in domestic and foreign markets services. Also the possibility is prescribed that the companies for financial participation take part in each group of foreign law which has as its subject in performance of one or more of the mentioned professions, in order to create international, primarily European network of companies for performing liberal professions. Multi-professional holding has certain specific characteristics in relation to the holding of general law, among which are of particular importance two protective measures: more than half of the capital and voting rights of the holding company should hold the professionals who exercise their profession in the branches; the management board shall be elected among the members who perform their professions in the branches. Holding of the liberal professions has its own

  9. The Challenge of Assessing Professional Competence in Work Integrated Learning

    Science.gov (United States)

    McNamara, Judith

    2013-01-01

    A fundamental aspect of work integrated learning (WIL) is the development of professional competence, the ability of students to perform in the workplace. Alignment theory therefore suggests that the assessment of WIL should include an assessment of students' demonstration of professional competence in the workplace. The assessment of professional…

  10. Integration of a Professional Dancer into College

    Science.gov (United States)

    Pulinkala, Ivan

    2011-01-01

    This paper evaluates the experience of integrating a professional dancer into a collegiate environment using a case study method of qualitative research. Interviews, focus groups, observation studies and document analysis techniques were used to gather qualitative data for this study. The innovation of diffusion theory was used to highlight the…

  11. Evaluating Integrative Cancer Clinics With the Claim Assessment Profile: An Example With the InspireHealth Clinic.

    Science.gov (United States)

    Hilton, Lara; Elfenbaum, Pamela; Jain, Shamini; Sprengel, Meredith; Jonas, Wayne B

    2018-03-01

    The evaluation of freestanding integrative cancer clinical programs is challenging and is rarely done. We have developed an approach called the Claim Assessment Profile (CAP) to identify whether evaluation of a practice is justified, feasible, and likely to provide useful information. A CAP was performed in order to (1) clarify the healing claims at InspireHealth, an integrative oncology treatment program, by defining the most important impacts on its clients; (2) gather information about current research capacity at the clinic; and (3) create a program theory and path model for use in prospective research. This case study design incorporates methods from a variety of rapid assessment approaches. Procedures included site visits to observe the program, structured qualitative interviews with 26 providers and staff, surveys to capture descriptive data about the program, and observational data on program implementation. The InspireHealth program is a well-established, multi-site, thriving integrative oncology clinical practice that focuses on patient support, motivation, and health behavior engagement. It delivers patient-centered care via a standardized treatment protocol. There arehigh levels of research interest from staff and resources by which to conduct research. This analysis provides the primary descriptive and claims clarification of an integrative oncology treatment program, an evaluation readiness report, a detailed logic model explicating program theory, and a clinical outcomes path model for conducting prospective research. Prospective evaluation of this program would be feasible and valuable, adding to our knowledge base of integrative cancer therapies.

  12. Social learning in a longitudinal integrated clinical placement.

    Science.gov (United States)

    Roberts, Chris; Daly, Michele; Held, Fabian; Lyle, David

    2017-10-01

    Recent research has demonstrated that longitudinal integrated placements (LICs) are an alternative mode of clinical education to traditional placements. Extended student engagement in community settings provide the advantages of educational continuity as well as increased service provision in underserved areas. Developing and maintaining LICs require a differing approach to student learning than that for traditional placements. There has been little theoretically informed empirical research that has offered explanations of which are the important factors that promote student learning in LICs and the relationships between those factors. We explored the relationship between student learning, student perceptions of preparedness for practice and student engagement, in the context of a rural LIC. We used a sequential qualitative design employing thematic, comparative and relational analysis of data from student interviews (n = 18) to understand possible processes and mechanisms of student learning in the LIC. Through the theoretical lens of social learning systems, we identified two major themes; connectivity and preparedness for practice. Connectivity described engagement and relationship building by students, across formal and informal learning experiences, interprofessional interactions, social interactions with colleagues, interaction with patients outside of the clinical setting, and the extent of integration in the wider community. Preparedness for practice, reflected students' perceptions of having sufficient depth in clinical skills, personal and professional development, cultural awareness and understanding of the health system, to work in that system. A comparative analysis compared the nature and variation of learning across students. In a relational analysis, there was a positive association between connectivity and preparedness for practice. Connectivity is a powerful enabler of students' agentic engagement, collaboration, and learning within an LIC. It

  13. Designing Clinical Space for the Delivery of Integrated Behavioral Health and Primary Care.

    Science.gov (United States)

    Gunn, Rose; Davis, Melinda M; Hall, Jennifer; Heintzman, John; Muench, John; Smeds, Brianna; Miller, Benjamin F; Miller, William L; Gilchrist, Emma; Brown Levey, Shandra; Brown, Jacqueline; Wise Romero, Pam; Cohen, Deborah J

    2015-01-01

    This study sought to describe features of the physical space in which practices integrating primary care and behavioral health care work and to identify the arrangements that enable integration of care. We conducted an observational study of 19 diverse practices located across the United States. Practice-level data included field notes from 2-4-day site visits, transcripts from semistructured interviews with clinicians and clinical staff, online implementation diary posts, and facility photographs. A multidisciplinary team used a 4-stage, systematic approach to analyze data and identify how physical layout enabled the work of integrated care teams. Two dominant spatial layouts emerged across practices: type-1 layouts were characterized by having primary care clinicians (PCCs) and behavioral health clinicians (BHCs) located in separate work areas, and type-2 layouts had BHCs and PCCs sharing work space. We describe these layouts and the influence they have on situational awareness, interprofessional "bumpability," and opportunities for on-the-fly communication. We observed BHCs and PCCs engaging in more face-to-face methods for coordinating integrated care for patients in type 2 layouts (41.5% of observed encounters vs 11.7%; P < .05). We show that practices needed to strike a balance between professional proximity and private work areas to accomplish job tasks. Private workspace was needed for focused work, to see patients, and for consults between clinicians and clinical staff. We describe the ways practices modified and built new space and provide 2 recommended layouts for practices integrating care based on study findings. Physical layout and positioning of professionals' workspace is an important consideration in practices implementing integrated care. Clinicians, researchers, and health-care administrators are encouraged to consider the role of professional proximity and private working space when creating new facilities or redesigning existing space to foster

  14. Strengthening the Ties That Bind: Integrating Undergraduate Liberal and Professional Study. Report of the Professional Preparation Network.

    Science.gov (United States)

    Stark, Joan S.; Lowther, Malcolm A.

    The integration of undergraduate liberal and professional education is discussed in the following chapters: (1) "A Call to Action"; (2) "Binding Values, Changing Times and Curricular Balance"; (3) "Seizing Opportunities for Excellence"; (4) "Defining the Educated Professional"; (5) "Extending a Constructive Debate"; and (6) "A New Spirit of…

  15. Integration in primary community care networks (PCCNs: examination of governance, clinical, marketing, financial, and information infrastructures in a national demonstration project in Taiwan

    Directory of Open Access Journals (Sweden)

    Lin Blossom Yen-Ju

    2007-06-01

    Full Text Available Abstract Background Taiwan's primary community care network (PCCN demonstration project, funded by the Bureau of National Health Insurance on March 2003, was established to discourage hospital shopping behavior of people and drive the traditional fragmented health care providers into cooperate care models. Between 2003 and 2005, 268 PCCNs were established. This study profiled the individual members in the PCCNs to study the nature and extent to which their network infrastructures have been integrated among the members (clinics and hospitals within individual PCCNs. Methods The thorough questionnaire items, covering the network working infrastructures – governance, clinical, marketing, financial, and information integration in PCCNs, were developed with validity and reliability confirmed. One thousand five hundred and fifty-seven clinics that had belonged to PCCNs for more than one year, based on the 2003–2005 Taiwan Primary Community Care Network List, were surveyed by mail. Nine hundred and twenty-eight clinic members responded to the surveys giving a 59.6 % response rate. Results Overall, the PCCNs' members had higher involvement in the governance infrastructure, which was usually viewed as the most important for establishment of core values in PCCNs' organization design and management at the early integration stage. In addition, it found that there existed a higher extent of integration of clinical, marketing, and information infrastructures among the hospital-clinic member relationship than those among clinic members within individual PCCNs. The financial infrastructure was shown the least integrated relative to other functional infrastructures at the early stage of PCCN formation. Conclusion There was still room for better integrated partnerships, as evidenced by the great variety of relationships and differences in extent of integration in this study. In addition to provide how the network members have done for their initial work at

  16. How Health Care Professionals Use Social Media to Create Virtual Communities: An Integrative Review.

    Science.gov (United States)

    Rolls, Kaye; Hansen, Margaret; Jackson, Debra; Elliott, Doug

    2016-06-16

    Prevailing health care structures and cultures restrict intraprofessional communication, inhibiting knowledge dissemination and impacting the translation of research into practice. Virtual communities may facilitate professional networking and knowledge sharing in and between health care disciplines. This study aimed to review the literature on the use of social media by health care professionals in developing virtual communities that facilitate professional networking, knowledge sharing, and evidence-informed practice. An integrative literature review was conducted to identify research published between 1990 and 2015. Search strategies sourced electronic databases (PubMed, CINAHL), snowball references, and tables of contents of 3 journals. Papers that evaluated social media use by health care professionals (unless within an education framework) using any research design (except for research protocols or narrative reviews) were included. Standardized data extraction and quality assessment tools were used. Overall, 72 studies were included: 44 qualitative (including 2 ethnographies, 26 qualitative descriptive, and 1 Q-sort) and 20 mixed-methods studies, and 8 literature reviews. The most common methods of data collection were Web-based observation (n=39), surveys (n=23), interviews (n=11), focus groups (n=2), and diaries (n=1). Study quality was mixed. Social media studied included Listservs (n=22), Twitter (n=18), general social media (n=17), discussion forums (n=7), Web 2.0 (n=3), virtual community of practice (n=3), wiki (n=1), and Facebook (n=1). A range of health care professionals were sampled in the studies, including physicians (n=24), nurses (n=15), allied health professionals (n=14), followed by health care professionals in general (n=8), a multidisciplinary clinical specialty area (n=9), and midwives (n=2). Of 36 virtual communities, 31 were monodiscipline for a discrete clinical specialty. Population uptake by the target group ranged from 1.6% to 29% (n

  17. Analysis of professional competencies for the clinical research data management profession: implications for training and professional certification.

    Science.gov (United States)

    Zozus, Meredith N; Lazarov, Angel; Smith, Leigh R; Breen, Tim E; Krikorian, Susan L; Zbyszewski, Patrick S; Knoll, Shelly K; Jendrasek, Debra A; Perrin, Derek C; Zambas, Demetris N; Williams, Tremaine B; Pieper, Carl F

    2017-07-01

    To assess and refine competencies for the clinical research data management profession. Based on prior work developing and maintaining a practice standard and professional certification exam, a survey was administered to a captive group of clinical research data managers to assess professional competencies, types of data managed, types of studies supported, and necessary foundational knowledge. Respondents confirmed a set of 91 professional competencies. As expected, differences were seen in job tasks between early- to mid-career and mid- to late-career practitioners. Respondents indicated growing variability in types of studies for which they managed data and types of data managed. Respondents adapted favorably to the separate articulation of professional competencies vs foundational knowledge. The increases in the types of data managed and variety of research settings in which data are managed indicate a need for formal education in principles and methods that can be applied to different research contexts (ie, formal degree programs supporting the profession), and stronger links with the informatics scientific discipline, clinical research informatics in particular. The results document the scope of the profession and will serve as a foundation for the next revision of the Certified Clinical Data Manager TM exam. A clear articulation of professional competencies and necessary foundational knowledge could inform the content of graduate degree programs or tracks in areas such as clinical research informatics that will develop the current and future clinical research data management workforce. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  18. How does teaching clinical skills influence instructors' professional behaviour?

    Directory of Open Access Journals (Sweden)

    Yamani N

    2004-07-01

    Full Text Available Purpose: "Introduction to Clinical Medicine" in Isfahan University of Medical Sciences and Health Services is an initiative in which general practitioners work as instructors and have the opportunity to experience teaching in addition to clinical practice. Since teaching, affects both teacher and students, this study aims to assess the influence of teaching clinical skills on the instructors' psychological, social and professional behaviour. Methods: This was performed as a qualitative study. The research population consisted of instructors of “Introduction to Clinical Medicine” who were all general practitioners and acted as facilitator in small groups working on physical examination and case discussion. The data collecting tool was a semi-structured interview which was recorded on the tape. Then, the interviews were transcribed and confirmed by interviewees at the end. 10 instructors were interviewed. The data were analysed according to Colaizzi model. Results: After coding the data to 38 main subjects, they were classified into three main categories including professional, psychological and social effects. The influence of teaching on professional performance included performing a thorough and correct physical examination, taking a detailed and correct history, increasing decision making ability and increasing professional knowledge. Some of the psychological effects were increasing selfconfidence, job satisfaction and morale. The social effects of teaching were increasing social contacts, having a relationship with an academic environment and having a respectful job. Conclusion: Considering the positive effects of teaching on instructors, teaching clinical skills by general practitioners can increase general practitioners knowledge and clinical skills and improve their morale. It is recommended to train general practitioners both for teaching skills and clinical skills and consider this, as an opportunity for physicians’ continuing

  19. OPPORTUNITIES FOR HUMAN RESOURCES DEVELOPMENT BY PROFESSIONAL INTEGRATION / REINTEGRATION

    Directory of Open Access Journals (Sweden)

    LAVINIA ELISABETA POPP

    2012-01-01

    Full Text Available The present paper presents some opportunities for the development of human resources by means of professional insertion / reinsertion. It is about an intervention project, more precisely the establishment of a Centre for Career Counselling and Professional Requalification (CORP within the University “Eftimie Murgu” of Reşita. The objective was the promotion of an inclusive society able to facilitate the access and integration on the labour market of the young unemployed. By its activities, the project forwards an inclusive model of social inclusion of the professionally inactive young people through individualised programmes of qualification - requalification, support and professional counselling. By its results the project contributed to the stimulation of the participation of young unemployed persons to the social, economic and educational life, the consideration of the importance of the role played by education and professional training among the youth.

  20. Assessing Professionalism: A Theoretical Framework for Defining Clinical Rotation Assessment Criteria.

    Science.gov (United States)

    Armitage-Chan, Elizabeth

    Although widely accepted as an important graduate competence, professionalism is a challenging outcome to define and assess. Clinical rotations provide an excellent opportunity to develop student professionalism through the use of experiential learning and effective feedback, but without appropriate theoretical frameworks, clinical teachers may find it difficult to identify appropriate learning outcomes. The adage "I know it when I see it" is unhelpful in providing feedback and guidance for student improvement, and criteria that are more specifically defined would help students direct their own development. This study sought first to identify how clinical faculty in one institution currently assess professionalism, using retrospective analysis of material obtained in undergraduate teaching and faculty development sessions. Subsequently, a faculty workshop was held in which a round-table type discussion sought to develop these ideas and identify how professionalism assessment could be improved. The output of this session was a theoretical framework for teaching and assessing professionalism, providing example assessment criteria and ideas for clinical teaching. This includes categories such as client and colleague interaction, respect and trust, recognition of limitations, and understanding of different professional identities. Each category includes detailed descriptions of the knowledge, skills, and behaviors expected of students in these areas. The criteria were determined by engaging faculty in the development of the framework, and therefore they should represent a focused development of criteria already used to assess professionalism, and not a novel and unfamiliar set of assessment guidelines. The faculty-led nature of this framework is expected to facilitate implementation in clinical teaching.

  1. Disaster Preparedness among Health Professionals and Support Staff: What is Effective? An Integrative Literature Review.

    Science.gov (United States)

    Gowing, Jeremy R; Walker, Kim N; Elmer, Shandell L; Cummings, Elizabeth A

    2017-06-01

    Introduction It is important that health professionals and support staff are prepared for disasters to safeguard themselves and the community during disasters. There has been a significantly heightened focus on disasters since the terrorist attacks of September 11, 2001 in New York (USA); however, despite this, it is evident that health professionals and support staff may not be adequately prepared for disasters. Report An integrative literature review was performed based on a keyword search of the major health databases for primary research evaluating preparedness of health professionals and support staff. The literature was quality appraised using a mixed-methods appraisal tool (MMAT), and a thematic analysis was completed to identify current knowledge and gaps. Discussion The main themes identified were: health professionals and support staff may not be fully prepared for disasters; the most effective content and methods for disaster preparedness is unknown; and the willingness of health professionals and support staff to attend work and perform during disasters needs further evaluation. Gaps were identified to guide further research and the creation of new knowledge to best prepare for disasters. These included the need for: high-quality research to evaluate the best content and methods of disaster preparedness; inclusion of the multi-disciplinary health care team as participants; preparation for internal disasters; the development of validated competencies for preparedness; validated tools for measurement; and the importance of performance in actual disasters to evaluate preparation. The literature identified that all types of disaster preparedness activities lead to improvements in knowledge, skills, or attitude preparedness for disasters. Most studies focused on external disasters and the preparedness of medical, nursing, public health, or paramedic professionals. There needs to be a greater focus on the whole health care team, including allied health

  2. Development of a simple 12-item theory-based instrument to assess the impact of continuing professional development on clinical behavioral intentions.

    Directory of Open Access Journals (Sweden)

    France Légaré

    Full Text Available Decision-makers in organizations providing continuing professional development (CPD have identified the need for routine assessment of its impact on practice. We sought to develop a theory-based instrument for evaluating the impact of CPD activities on health professionals' clinical behavioral intentions.Our multipronged study had four phases. 1 We systematically reviewed the literature for instruments that used socio-cognitive theories to assess healthcare professionals' clinically-oriented behavioral intentions and/or behaviors; we extracted items relating to the theoretical constructs of an integrated model of healthcare professionals' behaviors and removed duplicates. 2 A committee of researchers and CPD decision-makers selected a pool of items relevant to CPD. 3 An international group of experts (n = 70 reached consensus on the most relevant items using electronic Delphi surveys. 4 We created a preliminary instrument with the items found most relevant and assessed its factorial validity, internal consistency and reliability (weighted kappa over a two-week period among 138 physicians attending a CPD activity. Out of 72 potentially relevant instruments, 47 were analyzed. Of the 1218 items extracted from these, 16% were discarded as improperly phrased and 70% discarded as duplicates. Mapping the remaining items onto the constructs of the integrated model of healthcare professionals' behaviors yielded a minimum of 18 and a maximum of 275 items per construct. The partnership committee retained 61 items covering all seven constructs. Two iterations of the Delphi process produced consensus on a provisional 40-item questionnaire. Exploratory factorial analysis following test-retest resulted in a 12-item questionnaire. Cronbach's coefficients for the constructs varied from 0.77 to 0.85.A 12-item theory-based instrument for assessing the impact of CPD activities on health professionals' clinical behavioral intentions showed adequate validity and

  3. Developing a theory-based instrument to assess the impact of continuing professional development activities on clinical practice: a study protocol

    Directory of Open Access Journals (Sweden)

    Rousseau Michel

    2011-03-01

    Full Text Available Abstract Background Continuing professional development (CPD is one of the principal means by which health professionals (i.e. primary care physicians and specialists maintain, improve, and broaden the knowledge and skills required for optimal patient care and safety. However, the lack of a widely accepted instrument to assess the impact of CPD activities on clinical practice thwarts researchers' comparisons of the effectiveness of CPD activities. Using an integrated model for the study of healthcare professionals' behaviour, our objective is to develop a theory-based, valid, reliable global instrument to assess the impact of accredited CPD activities on clinical practice. Methods Phase 1: We will analyze the instruments identified in a systematic review of factors influencing health professionals' behaviours using criteria that reflect the literature on measurement development and CPD decision makers' priorities. The outcome of this phase will be an inventory of instruments based on social cognitive theories. Phase 2: Working from this inventory, the most relevant instruments and their related items for assessing the concepts listed in the integrated model will be selected. Through an e-Delphi process, we will verify whether these instruments are acceptable, what aspects need revision, and whether important items are missing and should be added. The outcome of this phase will be a new global instrument integrating the most relevant tools to fit our integrated model of healthcare professionals' behaviour. Phase 3: Two data collections are planned: (1 a test-retest of the new instrument, including item analysis, to assess its reliability and (2 a study using the instrument before and after CPD activities with a randomly selected control group to explore the instrument's mere-measurement effect. Phase 4: We will conduct individual interviews and focus groups with key stakeholders to identify anticipated barriers and enablers for implementing the

  4. Integrating research into clinical internship training bridging the science/practice gap in pediatric psychology.

    Science.gov (United States)

    McQuaid, Elizabeth L; Spirito, Anthony

    2012-03-01

    Existing literature highlights a critical gap between science and practice in clinical psychology. The internship year is a "capstone experience"; training in methods of scientific evaluation should be integrated with the development of advanced clinical competencies. We provide a rationale for continued exposure to research during the clinical internship year, including, (a) critical examination and integration of the literature regarding evidence-based treatment and assessment, (b) participation in faculty-based and independent research, and (c) orientation to the science and strategy of grantsmanship. Participation in research provides exposure to new empirical models and can foster the development of applied research questions. Orientation to grantsmanship can yield an initial sense of the "business of science." Internship provides an important opportunity to examine the challenges to integrating the clinical evidence base into professional practice; for that reason, providing research exposure on internship is an important strategy in training the next generation of pediatric psychologists.

  5. Integrating Research Into Clinical Internship Training Bridging the Science/Practice Gap in Pediatric Psychology

    Science.gov (United States)

    Spirito, Anthony

    2012-01-01

    Existing literature highlights a critical gap between science and practice in clinical psychology. The internship year is a “capstone experience”; training in methods of scientific evaluation should be integrated with the development of advanced clinical competencies. We provide a rationale for continued exposure to research during the clinical internship year, including, (a) critical examination and integration of the literature regarding evidence-based treatment and assessment, (b) participation in faculty-based and independent research, and (c) orientation to the science and strategy of grantsmanship. Participation in research provides exposure to new empirical models and can foster the development of applied research questions. Orientation to grantsmanship can yield an initial sense of the “business of science.” Internship provides an important opportunity to examine the challenges to integrating the clinical evidence base into professional practice; for that reason, providing research exposure on internship is an important strategy in training the next generation of pediatric psychologists. PMID:22286345

  6. Interprofessional education through shadowing experiences in multi-disciplinary clinical settings

    Directory of Open Access Journals (Sweden)

    Moore Ainsley E

    2010-12-01

    Full Text Available Abstract The World Health Organization has recently added Interprofessional Education (IPE to its global health agenda recognizing it as a necessary component of all health professionals' education. We suggest mandatory interprofessional shadowing experiences as a mechanism to be used by chiropractic institutions to address this agenda. IPE initiatives of other professions (pharmacy and medicine are described along with chiropractic. This relative comparison of professions local to our jurisdiction in Ontario, Canada is made so that the chiropractic profession may take note that they are behind other health care providers in implementing IPE. Interprofessional shadowing experiences would likely take place in a multi-disciplinary clinical setting. We offer an example of how two separate professions within a Family Health Team (FHT can work together in such a setting to enhance both student learning and patient care. For adult learners, using interprofessional shadowing experiences with learner-derived and active objectives across diverse health professional groups may help to improve the educational experience. Mandatory interprofessional shadowing experiences for chiropractors during their training can enhance future collaborative practice and provide success in reaching a goal common to each profession - improved patient care.

  7. Integrated monitoring: Setting new standards for the next decade of clinical trial practice

    Directory of Open Access Journals (Sweden)

    Kamala Rai

    2011-01-01

    Full Text Available The new age clinical research professional is now geared toward an "integrated monitoring" approach. A number of critical activities at the site level and at the sponsor′s organization need convergence to harness rich dividends in early study start and quick close of the study. The field monitor needs full integration to ensure standard of care, train the site in protocol, select the right site, ensure regulatory support, ensure excellent project management skills, coach, support the logistics team, manage the vendor, ensure good documentation practices, develop patient recruitment and retention, lean the applicable process, as well as ensure effective site management amongst the myriad activities assigned toward developing the drug in the clinic.

  8. The DSM and Professional Practice: Research, Clinical, and Institutional Perspectives.

    Science.gov (United States)

    Halpin, Michael

    2016-06-01

    How mental illnesses are defined has significant ramifications, given the substantial social and individual repercussions of these conditions. Using actor-network theory, I analyze how mental health professionals use the Diagnostic and Statistical Manual of Mental Disorders (DSM) in their work. Drawing on observations of a neuropsychological laboratory and interviews with 27 professionals (i.e., psychiatrists, psychologists), I investigate how the DSM is used in research, clinical, and institutional work. In research, the DSM influences study design and exclusion/inclusion criteria. In the clinic, the DSM influences how disorders are conceptualized and diagnosed. Institutionally, the DSM aligns the patient-professional encounter to insurance and pharmaceutical interests. I conclude that the DSM operates as multiple, context-specific taxonomies that pervasively influence professional practices, such that all possible actions must orient to DSM criteria, with professionals both a source and an object of institutionalized gaze. © American Sociological Association 2016.

  9. The theory of planned behaviour in medical education: a model for integrating professionalism training.

    Science.gov (United States)

    Archer, Ray; Elder, William; Hustedde, Carol; Milam, Andrea; Joyce, Jennifer

    2008-08-01

    Teaching and evaluating professionalism remain important issues in medical education. However, two factors hinder attempts to integrate curricular elements addressing professionalism into medical school training: there is no common definition of medical professionalism used across medical education, and there is no commonly accepted theoretical model upon which to integrate professionalism into the curriculum. This paper proposes a definition of professionalism, examines this definition in the context of some of the previous definitions of professionalism and connects this definition to the attitudinal roots of professionalism. The problems described above bring uncertainty about the best content and methods with which to teach professionalism in medical education. Although various aspects of professionalism have been incorporated into medical school curricula, content, teaching and evaluation remain controversial. We suggest that intervening variables, which may augment or interfere with medical students' implementation of professionalism knowledge, skills and, therefore, attitudes, may go unaddressed. We offer a model based on the theory of planned behaviour (TPB), which describes the relationships of attitudes, social norms and perceived behavioural control with behaviour. It has been used to predict a wide range of behaviours, including doctor professional behaviours. Therefore, we propose an educational model that expands the TPB as an organisational framework that can integrate professionalism training into medical education. We conclude with a discussion about the implications of using this model to transform medical school curricula to develop positive professionalism attitudes, alter the professionalism social norms of the medical school and increase students' perceived control over their behaviours.

  10. Measuring Multi-Membership in Economic Integration and Its Trade Impact

    DEFF Research Database (Denmark)

    Afesorgbor, Sylvanus Kwaku; van Bergeijk, Peter A.G.

    2014-01-01

    impact in two major African regional blocs, Economic Community of West Africa States (ECOWAS) and Southern Africa Development Community (SADC). We find that the impact of multi-membership critically depends on the characteristics of the multi-membership of regional integration initiatives. We find...... a positive impact if an additional membership complements the integration process of the original regional integration initiative: overlapping memberships had a much stronger and significant positive effect on bilateral trade within ECOWAS compare with an insignificant impact within the SADC....

  11. Cultural similarities and differences in medical professionalism: a multi-region study.

    Science.gov (United States)

    Chandratilake, Madawa; McAleer, Sean; Gibson, John

    2012-03-01

    Over the last two decades, many medical educators have sought to define professionalism. Initial attempts to do so were focused on defining professionalism in a manner that allowed for universal agreement. This quest was later transformed into an effort to 'understand professionalism' as many researchers realised that professionalism is a social construct and is culture-sensitive. The determination of cultural differences in the understanding of professionalism, however, has been subject to very little research, possibly because of the practical difficulties of doing so. In this multi-region study, we illustrate the universal and culture-specific aspects of medical professionalism as it is perceived by medical practitioners. Forty-six professional attributes were identified by reviewing the literature. A total of 584 medical practitioners, representing the UK, Europe, North America and Asia, participated in a survey in which they indicated the importance of each of these attributes. We determined the 'essentialness' of each attribute in different geographic regions using the content validity index, supplemented with kappa statistics. With acceptable levels of consensus, all regional groups identified 29 attributes as 'essential', thereby indicating the universality of these professional attributes, and six attributes as non-essential. The essentialness of the rest varied by regional group. This study has helped to identify regional similarities and dissimilarities in understandings of professionalism, most of which can be explained by cultural differences in line with the theories of cultural dimensions and cultural value. However, certain dissonances among regions may well be attributable to socio-economic factors. Some of the responses appear to be counter-cultural and demonstrate practitioners' keenness to overcome cultural barriers in order to provide better patient care. © Blackwell Publishing Ltd 2012.

  12. Integrated development environment for multi-core systems

    Directory of Open Access Journals (Sweden)

    Krunić Momčilo V.

    2014-01-01

    Full Text Available Development of the software application that provides comfortable working environment of embedded software applications was always a difficult task to achieve. To reach this goal it was necessary to integrate all specific tools designed for that purpose. This paper describes Integrated Development Environment (IDE that was developed to meet all specific needs of a software development for the family of multi-core target platforms designed for a digital signal processing in Cirrus Logic Company. Eclipse platform and RCP (Rich Client Platform was used as a basis, because it provides an extensible plug-in system for customizing the development environment. CLIDE (Cirrus Logic Integrated Development Environment represent the epilog of that effort, reliable IDE used for development of embedded applications. Validation of the solution is accomplished thru 2641 J Unit tests that validate most of the CLIDE's functionalities. Developed IDE (CLIDE significantly increases a quality of a software development for multi-core systems and reduces time-to-market, thereby justifying development costs.

  13. How Health Care Professionals Use Social Media to Create Virtual Communities: An Integrative Review

    Science.gov (United States)

    2016-01-01

    Background Prevailing health care structures and cultures restrict intraprofessional communication, inhibiting knowledge dissemination and impacting the translation of research into practice. Virtual communities may facilitate professional networking and knowledge sharing in and between health care disciplines. Objectives This study aimed to review the literature on the use of social media by health care professionals in developing virtual communities that facilitate professional networking, knowledge sharing, and evidence-informed practice. Methods An integrative literature review was conducted to identify research published between 1990 and 2015. Search strategies sourced electronic databases (PubMed, CINAHL), snowball references, and tables of contents of 3 journals. Papers that evaluated social media use by health care professionals (unless within an education framework) using any research design (except for research protocols or narrative reviews) were included. Standardized data extraction and quality assessment tools were used. Results Overall, 72 studies were included: 44 qualitative (including 2 ethnographies, 26 qualitative descriptive, and 1 Q-sort) and 20 mixed-methods studies, and 8 literature reviews. The most common methods of data collection were Web-based observation (n=39), surveys (n=23), interviews (n=11), focus groups (n=2), and diaries (n=1). Study quality was mixed. Social media studied included Listservs (n=22), Twitter (n=18), general social media (n=17), discussion forums (n=7), Web 2.0 (n=3), virtual community of practice (n=3), wiki (n=1), and Facebook (n=1). A range of health care professionals were sampled in the studies, including physicians (n=24), nurses (n=15), allied health professionals (n=14), followed by health care professionals in general (n=8), a multidisciplinary clinical specialty area (n=9), and midwives (n=2). Of 36 virtual communities, 31 were monodiscipline for a discrete clinical specialty. Population uptake by the

  14. Guiding role of typical cases in clinical training for ophthalmology professional degree graduate students

    Directory of Open Access Journals (Sweden)

    Zhe Wang

    2014-05-01

    Full Text Available With the change of the concept of graduate enrollment, the recruiting proportion of clinical medicine professional degree graduate students is more and more, and the training of professional degree graduate students is increasingly focusing on practical. In our experience in clinical training for ophthalmology professional degree graduate students, increasing the ward clinical practice time is important. For particular emphasis on the guiding role of the typical cases, each professional group combined their professional characteristics of the typical cases to instruct the graduate students, training their clinical diagnosis and treatment ability, training their microsurgical techniques. From clinical medical writing, record summary, literature review, professional degree graduate students could expand their knowledge structure, practice their thesis writing ability. Based on the typical cases, expansion of knowledge coverage, they could improve the ability of diagnosis and treatment for special disease cases. In this rigorous training system, professional degree graduate students can learn by analogy, and focus on typical cases to get the most intuitive panoramic understanding of the diseases, with a minimum of time to master the most clinical knowledge, to enrich clinical experience, and to lay the foundation for future work in the assessment.

  15. Indian nurses in Italy: a qualitative study of their professional and social integration.

    Science.gov (United States)

    Stievano, Alessandro; Olsen, Douglas; Tolentino Diaz, Ymelda; Sabatino, Laura; Rocco, Gennaro

    2017-12-01

    To investigate the lived subjective experiences of immigrant Indian nurses in Italy and specifically their professional and social integration. To study the worldwide, nursing flux is a health priority in the globalised world. The growth in migration trends among nurses, not only from Philippines or India, has proliferated in recent years. The research on nurses' mobility for Southern European countries is underexplored, and in Italy, the out-migration flows of Indian nurses were never analysed. Qualitative methodological approach. Semi-structured interviews (n = 20) were completed with Indian clinical nurses working in Italy for more than one year mainly in private organisations. A purposive sampling technique was used for recruitment. The data were then content-analysed using an inductive method. The findings were categorised into four themes: (1) aspects of professional integration and working experience, (2) intra- and interprofessional relationships and perceptions of the IPASVI Regulatory Nursing Board, (3) initial nursing education and continuous professional development and (4) perceptions of social integration. The results show that for Indian nurses in Italy emigration is important to gain opportunities to expand economic and social privileges as well as escape from historical assumptions of stigma associated with nursing work, especially for women. However, these conclusions have to be seen in wider socio-cultural complexities that are at the basis of transnational fluxes (Prescott & Nichter ). The research offers an insight into the complicated reasons for Indian nurses out-migration to Italy. Without comprehending the interwoven textures of the political and social relations that are continually constructed and re-constructed among different nations, it is difficult to understand nurses out-migration and consequently have a better and safer collaborative teamwork in the host countries. © 2017 John Wiley & Sons Ltd.

  16. Integrated multi-scale modelling and simulation of nuclear fuels

    International Nuclear Information System (INIS)

    Valot, C.; Bertolus, M.; Masson, R.; Malerba, L.; Rachid, J.; Besmann, T.; Phillpot, S.; Stan, M.

    2015-01-01

    This chapter aims at discussing the objectives, implementation and integration of multi-scale modelling approaches applied to nuclear fuel materials. We will first show why the multi-scale modelling approach is required, due to the nature of the materials and by the phenomena involved under irradiation. We will then present the multiple facets of multi-scale modelling approach, while giving some recommendations with regard to its application. We will also show that multi-scale modelling must be coupled with appropriate multi-scale experiments and characterisation. Finally, we will demonstrate how multi-scale modelling can contribute to solving technology issues. (authors)

  17. Clinical safety and professional liability claims in Ophthalmology.

    Science.gov (United States)

    Dolz-Güerri, F; Gómez-Durán, E L; Martínez-Palmer, A; Castilla Céspedes, M; Arimany-Manso, J

    2017-11-01

    Patient safety is an international public health priority. Ophthalmology scientific societies and organisations have intensified their efforts in this field. As a tool to learn from errors, these efforts have been linked to the management of medical professional liability insurance through the analysis of claims. A review is performed on the improvements in patient safety, as well as professional liability issues in Ophthalmology. There is a high frequency of claims and risk of economic reparation of damage in the event of a claim in Ophthalmology. Special complaints, such as wrong surgery or lack of information, have a high risk of financial compensation and need strong efforts to prevent these potentially avoidable events. Studies focused on pathologies or specific procedures provide information of special interest to sub-specialists. The specialist in Ophthalmology, like any other doctor, is subject to the current legal provisions and appropriate mandatory training in the medical-legal aspects of health care is essential. Professionals must be aware of the fundamental aspects of medical professional liability, as well as specific aspects, such as defensive medicine and clinical safety. The understanding of these medical-legal aspects in the routine clinical practice can help to pave the way towards a satisfactory and safe professional career, and help in increasing patient safety. The aim of this review is to contribute to this training, for the benefit of professionals and patients. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. A Systematic Approach to Find a Professional Audiology Clinic: Patient-Based Information

    Science.gov (United States)

    Kim, Gungu; Kim, Gibbeum; Na, Wondo

    2016-01-01

    This brief communication introduced a systematic way to find a professional audiology clinic developed for patients and professionals by the American Academy of Audiology, American Speech-Language-Hearing Association, and Healthy Hearing. Patients can access each organization's website to find professionals and/or clinics based on criteria such as location, hours, special areas, types of service, reviews and rating by previous patients, and kinds of insurance accepted. Such a system may protect the patients from information overload, guarantee accurate information, and help them find themselves professional audiologists who can assist them. We expect professional organizations to adopt this system as soon as possible and link hearing-impaired patients with professional audiologists in Korea. PMID:27626086

  19. Tracing the evolution of chiropractic students’ confidence in clinical and patient communication skills during a clinical internship: a multi-methods study

    Science.gov (United States)

    2012-01-01

    Background Anecdotal evidence points to variations in individual students’ evolving confidence in clinical and patient communication skills during a clinical internship. A better understanding of the specific aspects of internships that contribute to increasing or decreasing confidence is needed to best support students during the clinical component of their study. Methods A multi-method approach, combining two large-scale surveys with 269 students and three in-depth individual interviews with a sub-sample of 29 students, was used to investigate the evolution of change in student confidence during a 10-month long internship. Change in levels of confidence in patient communication and clinical skills was measured and relationship to demographic factors were explored. The interviews elicited students’ accounts and reflections on what affected the evolution of their confidence during the internship. Results At the start of their internship, students were more confident in their patient communication skills than their clinical skills but prior experience was significantly related to confidence in both. Initial confidence in patient communication skills was also related to age and prior qualification but not gender whilst confidence in clinical skills was related to gender but not age or prior qualification. These influences were maintained over time. Overall, students’ levels of confidence in patient communication and clinical skills confidence increased significantly over the duration of the internship with evidence that change over time in these two aspects were inter-related. To explore how specific aspects of the internship contributed to changing levels of confidence, two extreme sub-groups of interviewees were identified, those with the least increase and those with the highest increase in professional confidence over time. A number of key factors affecting the development of confidence were identified, including among others, interactions with clinicians

  20. Tracing the evolution of chiropractic students' confidence in clinical and patient communication skills during a clinical internship: a multi-methods study.

    Science.gov (United States)

    Hecimovich, Mark; Volet, Simone

    2012-06-19

    Anecdotal evidence points to variations in individual students' evolving confidence in clinical and patient communication skills during a clinical internship. A better understanding of the specific aspects of internships that contribute to increasing or decreasing confidence is needed to best support students during the clinical component of their study. A multi-method approach, combining two large-scale surveys with 269 students and three in-depth individual interviews with a sub-sample of 29 students, was used to investigate the evolution of change in student confidence during a 10-month long internship. Change in levels of confidence in patient communication and clinical skills was measured and relationship to demographic factors were explored. The interviews elicited students' accounts and reflections on what affected the evolution of their confidence during the internship. At the start of their internship, students were more confident in their patient communication skills than their clinical skills but prior experience was significantly related to confidence in both. Initial confidence in patient communication skills was also related to age and prior qualification but not gender whilst confidence in clinical skills was related to gender but not age or prior qualification. These influences were maintained over time. Overall, students' levels of confidence in patient communication and clinical skills confidence increased significantly over the duration of the internship with evidence that change over time in these two aspects were inter-related. To explore how specific aspects of the internship contributed to changing levels of confidence, two extreme sub-groups of interviewees were identified, those with the least increase and those with the highest increase in professional confidence over time. A number of key factors affecting the development of confidence were identified, including among others, interactions with clinicians and patients, personal agency and

  1. COLLECTIVE PROFESSIONAL DEVELOPMENT FOR THE INTEGRATION OF ICT IN HIGHER EDUCATION

    DEFF Research Database (Denmark)

    Castro Guzman, Willy

    integration, and the teacher professional development as means to promote adoption. With the recognition of the potential of ICT in education, the study reflects the appropriateness of the dominant traditional approach to the first and second-order barriers to technology and attempts to overcome......In this thesis, I explore, analyse and reflect on the individual practice of adoption and the collective practice of integration of technology in teaching and learning in a Higher Education Institution. The study addresses the connections between ICT adoption in Education, the barriers of ICT...... the tradition of Cultural-Historical Activity Theory and brings significant changes in comparison with more traditional approaches in professional development to ICT adoption. The results of the intervention supports the idea of the need for changes in professional development to develop the professors’ agency...

  2. A new multi-component hierarchy and its integrable expanding model

    International Nuclear Information System (INIS)

    Dong Huanhe; Liang Xiangqian

    2008-01-01

    A set of multi-component matrix Lie algebra is constructed, it follows that a type of new loop algebra is presented and multi-component integrable hierarchy is obtained. Furthermore, the loop algebra is expanded into a larger one and a type of integrable coupling system is worked out. As reduction of the hierarchy, some well-known hierarchy such as DNLS, KN, CLL hierarchy are established

  3. [Clinical ethics consultation - an integrative model for practice and reflection].

    Science.gov (United States)

    Reiter-Theil, Stella

    2008-07-01

    Broad evidence exists that health care professionals are facing ethical difficulties in patient care demanding a spectrum of useful ethics support services. Clinical ethics consultation is one of these forms of ethics support being effective in the acute setting. An authentic case is presented as an illustration. We introduce an integrative model covering the activities being characteristic for ethics consultation and going beyond "school"-specific approaches. Finally, we formulate some do's and don'ts of ethics consultation that are considered to be key issues for successful practice.

  4. Genetic counselors' views and experiences with the clinical integration of genome sequencing.

    Science.gov (United States)

    Machini, Kalotina; Douglas, Jessica; Braxton, Alicia; Tsipis, Judith; Kramer, Kate

    2014-08-01

    In recent years, new sequencing technologies known as next generation sequencing (NGS) have provided scientists the ability to rapidly sequence all known coding as well as non-coding sequences in the human genome. As the two emerging approaches, whole exome (WES) and whole genome (WGS) sequencing, have started to be integrated in the clinical arena, we sought to survey health care professionals who are likely to be involved in the implementation process now and/or in the future (e.g., genetic counselors, geneticists and nurse practitioners). Two hundred twenty-one genetic counselors- one third of whom currently offer WES/WGS-participated in an anonymous online survey. The aims of the survey were first, to identify barriers to the implementation of WES/WGS, as perceived by survey participants; second, to provide the first systematic report of current practices regarding the integration of WES/WGS in clinic and/or research across the US and Canada and to illuminate the roles and challenges of genetic counselors participating in this process; and third to evaluate the impact of WES/WGS on patient care. Our results showed that genetic counseling practices with respect to WES/WGS are consistent with the criteria set forth in the ACMG 2012 policy statement, which highlights indications for testing, reporting, and pre/post test considerations. Our respondents described challenges related to offering WES/WGS, which included billing issues, the duration and content of the consent process, result interpretation and disclosure of incidental findings and variants of unknown significance. In addition, respondents indicated that specialty area (i.e., prenatal and cancer), lack of clinical utility of WES/WGS and concerns about interpretation of test results were factors that prevented them from offering this technology to patients. Finally, study participants identified the aspects of their professional training which have been most beneficial in aiding with the integration of

  5. Effect of mentoring on professional values in model C clinical nurse leader graduates.

    Science.gov (United States)

    Gazaway, Shena B; Anderson, Lori; Schumacher, Autumn; Alichnie, Chris

    2018-04-19

    Nursing graduates acquire their nursing values by professional socialization. Mentoring is a crucial support mechanism for these novice nurses, yet little is known about the model C clinical nurse leader graduate and the effects of mentoring. This investigation examined how mentoring affected the development of professional nursing values in the model C clinical nurse leader graduate. A longitudinal design was used to survey model C clinical nurse leader graduates before and after graduation to determine how different types of mentoring relationships influenced professional values. Demographic surveys documented participant characteristics and the Nurses Professional Values Scale - Revised (NPVS-R) assessed professional nursing values. Mean NPVS-R scores increased after graduation for the formally mentored participants, while the NPVS-R scores decreased or remained unchanged for the other mentoring groups. However, no significant difference was found in NPVS-R scores over time (p = .092) or an interaction between the NPVS-R scores and type of mentoring relationships (p = .09). These results suggest that model C clinical nurse leader graduate participants experiencing formal mentoring may develop professional nursing values more than their colleagues. Formal mentoring relationships are powerful and should be used to promote professional values for model C clinical nurse leader graduates. © 2018 John Wiley & Sons Ltd.

  6. Towards an Integrated Approach to the Recognition of Professional Competence and Academic Learning

    Science.gov (United States)

    Bravenboer, Darryll; Lester, Stan

    2016-01-01

    Purpose: The purpose of this paper is to discuss the benefits of reclaiming the idea of professional competence and challenges fragmented approaches to academic qualification and professional recognition. It is argued that academic programmes that are integrated with the requirements for professional recognition can resolve the potentially…

  7. Opinions of maternity care professionals and other stakeholders about integration of maternity care: a qualitative study in the Netherlands.

    Science.gov (United States)

    Perdok, Hilde; Jans, Suze; Verhoeven, Corine; Henneman, Lidewij; Wiegers, Therese; Mol, Ben Willem; Schellevis, François; de Jonge, Ank

    2016-07-26

    This study aims to give insight into the opinions of maternity care professionals and other stakeholders on the integration of midwife-led care and obstetrician-led care and on the facilitating and inhibiting factors for integrating maternity care. Qualitative study using interviews and focus groups from November 2012 to February 2013 in the Netherlands. Seventeen purposively selected stakeholder representatives participated in individual semi-structured interviews and 21 in focus groups. One face-to-face focus group included a combined group of midwives, obstetricians and a paediatrician involved in maternity care. Two online focus groups included a group of primary care midwives and a group of clinical midwives respectively. Thematic analysis was performed using Atlas.ti. Two researchers independently coded the interview and focus group transcripts by means of a mind map and themes and relations between them were described. Three main themes were identified with regard to integrating maternity care: client-centred care, continuity of care and task shifting between professionals. Opinions differed regarding the optimal maternity care organisation model. Participants considered the current payment structure an inhibiting factor, whereas a new modified payment structure based on the actual amount of work performed was seen as a facilitating factor. Both midwives and obstetricians indicated that they were afraid to loose autonomy. An integrated maternity care system may improve client-centred care, provide continuity of care for women during labour and birth and include a shift of responsibilities between health care providers. However, differences of opinion among professionals and other stakeholders with regard to the optimal maternity care organisation model may complicate the implementation of integrated care. Important factors for a successful implementation of integrated maternity care are an appropriate payment structure and maintenance of the autonomy of

  8. Role in forming of professional mobility in the future masters of pedagogics in terms of European integration

    OpenAIRE

    Nataliya Korobko

    2015-01-01

    This article describes the relevance of the formation of future professional mobility Masters of Pedagogics in terms of european integration processes. Analyzed the concept of «professional mobility» scientists of different sciences. Posted copyright definition of «professional mobility». The role of professional mobility in terms of european integration

  9. Working atmosphere, job satisfaction and individual characteristics of community mental health professionals in integrated care.

    Science.gov (United States)

    Goetz, Katja; Kleine-Budde, Katja; Bramesfeld, Anke; Stegbauer, Constance

    2018-03-01

    Working requirements of community mental healthcare professionals in integrated care are complex. There is a lack of research concerning the relation of job satisfaction, working atmosphere and individual characteristics. For the current study, a survey evaluating job satisfaction and working atmosphere of mental healthcare professionals in integrated care was performed. About 321 community mental healthcare professionals were included in the survey; the response rate was 59.5%. The professional background of community mental healthcare professionals included nursing, social work and psychology. Community mental healthcare professionals reported the highest satisfaction with colleagues and the lowest satisfaction with income. Moreover, it could be shown that more responsibility, more recognition and more variety in job tasks lead to an increase of overall job satisfaction. Healthcare for mentally ill patients in the community setting is complex and requires well-structured care with appropriate responsibilities within the team. A co-operative relationship among colleagues as well as clearly defined responsibilities seem to be the key for the job satisfaction of community mental healthcare professionals in integrated care. © 2017 John Wiley & Sons Ltd.

  10. SAFETY: an integrated clinical reasoning and reflection framework for undergraduate nursing students.

    Science.gov (United States)

    Hicks Russell, Bedelia; Geist, Melissa J; House Maffett, Jenny

    2013-01-01

    Nurse educators can no longer focus on imparting to students knowledge that is merely factual and content specific. Activities that provide students with opportunities to apply concepts in real-world scenarios can be powerful tools. Nurse educators should take advantage of student-patient interactions to model clinical reasoning and allow students to practice complex decision making throughout the entire curriculum. In response to this change in nursing education, faculty in a pediatric course designed a reflective clinical reasoning activity based on the SAFETY template, which is derived from the National Council of State Boards of Nursing RN practice analysis. Students were able to prioritize key components of nursing care, as well as integrate practice issues such as delegation, Health Insurance Portability and Accountability Act violations, and questioning the accuracy of orders. SAFETY is proposed as a framework for integration of content knowledge, clinical reasoning, and reflection on authentic professional nursing concerns. Copyright 2012, SLACK Incorporated.

  11. Adaptive control in multi-threaded iterated integration

    International Nuclear Information System (INIS)

    Doncker, Elise de; Yuasa, Fukuko

    2013-01-01

    In recent years we have developed a technique for the direct computation of Feynman loop-integrals, which are notorious for the occurrence of integrand singularities. Especially for handling singularities in the interior of the domain, we approximate the iterated integral using an adaptive algorithm in the coordinate directions. We present a novel multi-core parallelization scheme for adaptive multivariate integration, by assigning threads to the rule evaluations in the outer dimensions of the iterated integral. The method ensures a large parallel granularity as each function evaluation by itself comprises an integral over the lower dimensions, while the application of the threads is governed by the adaptive control in the outer level. We give computational results for a test set of 3- to 6-dimensional integrals, where several problems exhibit a loop integral behavior.

  12. Energy integration on multi-periods and multi-usages for hybrid electric and thermal powertrains

    International Nuclear Information System (INIS)

    Dimitrova, Zlatina; Maréchal, François

    2015-01-01

    The improvement of the efficiency of vehicle energy systems promotes an active search to find innovative solutions during the design process. This requires more accurate modeling of complex systems, which offers new ways to improve the design efficiency of energy systems. The vehicle is a highly dynamic system. The size and the efficiency of the convertors are dependent on the dynamic driving profile. In order to increase the energy efficiency, using energy integration techniques, an adapted methodology is required to choose the best points for the integrated system design. The idea is to clusterize the dynamic profile on typical multi-periods of the vehicle use. The energy system design is then optimized for these typical multi-periods. In this article a new methodology is applied on hybrid electric vehicles, in order to define the energy integrated powertrain configuration of the vehicle. The energy recovery potential of a single stage Organic Rankine Cycle for a thermal engine in combination with a hybrid electric powertrain is assessed for different drive cycles profiles and comfort situations. After the energy integration, a multi-objective optimization is applied to define the optimal design of a hybrid electric vehicle with a waste heat recovery system. - Highlights: • K-means algorithm transforms the dynamic driving profile on static multi-periods. • The clusters represent the typical powertrain use and size the heat recovery utility. • The maximal heat recovery potential on thermal powertrains is 11% for urban driving. • The maximal heat recovery potential on hybrid electric powertrains is 5%. • Engine downsizing increases heat recovery potential on hybrid electric powertrains

  13. Role in forming of professional mobility in the future masters of pedagogics in terms of European integration

    Directory of Open Access Journals (Sweden)

    Nataliya Korobko

    2015-04-01

    Full Text Available This article describes the relevance of the formation of future professional mobility Masters of Pedagogics in terms of european integration processes. Analyzed the concept of «professional mobility» scientists of different sciences. Posted copyright definition of «professional mobility». The role of professional mobility in terms of european integration

  14. THE RISKS IN SOCIO-PROFESSIONAL INTEGRATION OF YOUNG PEOPLE SUFFERING FROM AIDS

    Directory of Open Access Journals (Sweden)

    Daniela G. CALTEA

    2014-04-01

    Full Text Available The intention in writing this article is to provide a general presentation relating to Romanian HIV infected young people social-professional integration. It will speak in particularly about Iassy.The topics are: teenage, respectively youth as a stage in human being development, general aspects related to AIDS/HIV infection, statistics that include general information about Romanian (Iassy HIV infected youth, legislation about HIV infected people rights, HIV infected young people discrimination in the social-professional integration and preventive measures against discrimination.HIV/AIDS infection should not be a barrier in socio-professional integration way, and if a person is qualified and prepared in the field he/she wants to work, than that person should have all the benefits to be accepted in that job.We consider that employers mentality is based on the lack of information, which generates prejudice, fear against infected people, they are afraid to get HIV or to lose the rest of employees. We think that this fact must be changed.

  15. Quality assurance in clinical trials : a multi-disciplinary approach

    International Nuclear Information System (INIS)

    Cornes, D.

    2001-01-01

    Full text: Multi-disciplinary groups, such as medical physicists and radiation therapists, which work effectively together, can ensure continued improvements in radiation therapy quality. The same is also true for clinical trials, which have the added complication of requiring multi-institutional participation to collate sufficient data to effectively assess treatment benefits. It can be difficult to manage quality across all aspects of a multi-disciplinary and multi-institutional trial. A planned system of quality assurance is necessary to provide support for participating centres and facilitate a collaborative approach. To ensure protocol compliance a good relationship between the clinical trial group and treatment centre is idea with definition of mutual goals and objectives before and during the trial, and ongoing consultation and feedback throughout the trial process. To ensure good quality data and maximise the validity of results the study protocol must be strictly adhered to. Because of the need for meticulous attention to detail, both in treatment delivery and standards of documentation, clinical trials are often seen to further complicate the process of delivery of radiation therapy treatment. The Declaration of Helsinki and Good Clinical Practise Guidelines (adopted in May 1996, ICH) provide 'international ethical and scientific standards for designing, conducting, recording and reporting clinical research' and multi-disciplinary groups in each participating centre should also adhere to these guidelines. Copyright (2001) Australasian College of Physical Scientists and Engineers in Medicine

  16. Aerodynamic multi-objective integrated optimization based on principal component analysis

    Directory of Open Access Journals (Sweden)

    Jiangtao HUANG

    2017-08-01

    Full Text Available Based on improved multi-objective particle swarm optimization (MOPSO algorithm with principal component analysis (PCA methodology, an efficient high-dimension multi-objective optimization method is proposed, which, as the purpose of this paper, aims to improve the convergence of Pareto front in multi-objective optimization design. The mathematical efficiency, the physical reasonableness and the reliability in dealing with redundant objectives of PCA are verified by typical DTLZ5 test function and multi-objective correlation analysis of supercritical airfoil, and the proposed method is integrated into aircraft multi-disciplinary design (AMDEsign platform, which contains aerodynamics, stealth and structure weight analysis and optimization module. Then the proposed method is used for the multi-point integrated aerodynamic optimization of a wide-body passenger aircraft, in which the redundant objectives identified by PCA are transformed to optimization constraints, and several design methods are compared. The design results illustrate that the strategy used in this paper is sufficient and multi-point design requirements of the passenger aircraft are reached. The visualization level of non-dominant Pareto set is improved by effectively reducing the dimension without losing the primary feature of the problem.

  17. Path integral for multi-field inflation

    Energy Technology Data Exchange (ETDEWEB)

    Gong, Jinn-Ouk [Asia Pacific Center for Theoretical Physics, Pohang 37673 (Korea, Republic of); Department of Physics, Postech, Pohang 37673 (Korea, Republic of); Seo, Min-Seok [Center for Theoretical Physics of the Universe, Institute for Basic Science, 34051 Daejeon (Korea, Republic of); Shiu, Gary [Department of Physics, University of Wisconsin-Madison, Madison, WI 53706 (United States); Department of Physics & Institute for Advanced Study, Hong Kong University of Science and Technology, Clear Water Bay (Hong Kong)

    2016-07-20

    We develop the path integral formalism for studying cosmological perturbations in multi-field inflation, which is particularly well suited to study quantum theories with gauge symmetries such as diffeomorphism invariance. We formulate the gauge fixing conditions based on the Poisson brackets of the constraints, from which we derive two convenient gauges that are appropriate for multi-field inflation. We then adopt the in-in formalism to derive the most general expression for the power spectrum of the curvature perturbation including the corrections from the interactions of the curvature mode with other light degrees of freedom. We also discuss the contributions of the interactions to the bispectrum.

  18. Integrated topology optimisation of multi-energy networks

    NARCIS (Netherlands)

    Mazairac, L.A.J.; Salenbien, R.; Vanhoudt, D.; Desmedt, J.; Vries, de B.

    2015-01-01

    Multi-carrier hybrid energy distribution net- works provide flexibility in case of network malfunctions, energy shortages and price fluctuations through energy conversion and storage. Therefore hybrid networks can cope with large-scale integration of distributed and intermittent renewable energy

  19. Multi-symplectic variational integrators for nonlinear Schrödinger equations with variable coefficients

    International Nuclear Information System (INIS)

    Liao Cui-Cui; Cui Jin-Chao; Liang Jiu-Zhen; Ding Xiao-Hua

    2016-01-01

    In this paper, we propose a variational integrator for nonlinear Schrödinger equations with variable coefficients. It is shown that our variational integrator is naturally multi-symplectic. The discrete multi-symplectic structure of the integrator is presented by a multi-symplectic form formula that can be derived from the discrete Lagrangian boundary function. As two examples of nonlinear Schrödinger equations with variable coefficients, cubic nonlinear Schrödinger equations and Gross–Pitaevskii equations are extensively studied by the proposed integrator. Our numerical simulations demonstrate that the integrator is capable of preserving the mass, momentum, and energy conservation during time evolutions. Convergence tests are presented to verify that our integrator has second-order accuracy both in time and space. (paper)

  20. Functions of behavior change interventions when implementing multi-professional teamwork at an emergency department: a comparative case study.

    Science.gov (United States)

    Frykman, Mandus; Hasson, Henna; Athlin, Åsa Muntlin; von Thiele Schwarz, Ulrica

    2014-05-15

    While there is strong support for the benefits of working in multi-professional teams in health care, the implementation of multi-professional teamwork is reported to be complex and challenging. Implementation strategies combining multiple behavior change interventions are recommended, but the understanding of how and why the behavior change interventions influence staff behavior is limited. There is a lack of studies focusing on the functions of different behavior change interventions and the mechanisms driving behavior change. In this study, applied behavior analysis is used to analyze the function and impact of different behavior change interventions when implementing multi-professional teamwork. A comparative case study design was applied. Two sections of an emergency department implemented multi-professional teamwork involving changes in work processes, aimed at increasing inter-professional collaboration. Behavior change interventions and staff behavior change were studied using observations, interviews and document analysis. Using a hybrid thematic analysis, the behavior change interventions were categorized according to the DCOM® model. The functions of the behavior change interventions were then analyzed using applied behavior analysis. The two sections used different behavior change interventions, resulting in a large difference in the degree of staff behavior change. The successful section enabled staff performance of teamwork behaviors with a strategy based on ongoing problem-solving and frequent clarification of directions. Managerial feedback initially played an important role in motivating teamwork behaviors. Gradually, as staff started to experience positive outcomes of the intervention, motivation for teamwork behaviors was replaced by positive task-generated feedback. The functional perspective of applied behavior analysis offers insight into the behavioral mechanisms that describe how and why behavior change interventions influence staff

  1. Functions of behavior change interventions when implementing multi-professional teamwork at an emergency department: a comparative case study

    Science.gov (United States)

    2014-01-01

    Background While there is strong support for the benefits of working in multi-professional teams in health care, the implementation of multi-professional teamwork is reported to be complex and challenging. Implementation strategies combining multiple behavior change interventions are recommended, but the understanding of how and why the behavior change interventions influence staff behavior is limited. There is a lack of studies focusing on the functions of different behavior change interventions and the mechanisms driving behavior change. In this study, applied behavior analysis is used to analyze the function and impact of different behavior change interventions when implementing multi-professional teamwork. Methods A comparative case study design was applied. Two sections of an emergency department implemented multi-professional teamwork involving changes in work processes, aimed at increasing inter-professional collaboration. Behavior change interventions and staff behavior change were studied using observations, interviews and document analysis. Using a hybrid thematic analysis, the behavior change interventions were categorized according to the DCOM® model. The functions of the behavior change interventions were then analyzed using applied behavior analysis. Results The two sections used different behavior change interventions, resulting in a large difference in the degree of staff behavior change. The successful section enabled staff performance of teamwork behaviors with a strategy based on ongoing problem-solving and frequent clarification of directions. Managerial feedback initially played an important role in motivating teamwork behaviors. Gradually, as staff started to experience positive outcomes of the intervention, motivation for teamwork behaviors was replaced by positive task-generated feedback. Conclusions The functional perspective of applied behavior analysis offers insight into the behavioral mechanisms that describe how and why behavior

  2. Epistemology, development, and integrity in a science education professional development program

    Science.gov (United States)

    Hancock, Elizabeth St. Petery

    This research involved interpretive inquiry to understand changes in the notion of "self" as expressed by teachers recently enrolled as graduate students in an advanced degree program in science education at Florida State University. Teachers work in a context that integrates behavior, social structure, culture, and intention. Within this context, this study focused on the intentional realm that involves interior understandings, including self-epistemology, professional self-identity, and integrity. Scholarship in adult and teacher development, especially ways of knowing theory, guided my efforts to understand change in these notions of self. The five participants in this study were interviewed in depth to explore their "self"-related understandings in detail. The other primary data sources were portfolios and work the participants submitted as part of the program. Guided by a constructivist methodology, I used narrative inquiry and grounded theory to conduct data analysis. As learners and teachers, these individuals drew upon epistemological orientations emphasizing a procedural orientation to knowledge. They experienced varying degrees of interior and exterior development in self and epistemology. They created integrity in their efforts to align their intentions with their actions with a dynamic relationship to context. This study suggests that professional development experiences in science education include consideration of the personal and the professional, recognize and honor differing perspectives, facilitate development, and assist individuals to recognize and articulate their integrity.

  3. Social Integration as Professional Field: Psychotherapy in Sweden

    Directory of Open Access Journals (Sweden)

    Eva Johnsson

    2013-12-01

    Full Text Available The present article describes and analyses the emergence and development of a professional field called social integration. Ideas, theories, and occupational practices forming this field are explored, particularly those related to the development of a new discipline, that of psychotherapy. The development of three occupations (psychiatry, psychology and social work and their professionalisation is described through their qualitative and quantitative take‑offs in particular historical periods. Three periods are identified: formation, 1850-1920, when psychiatry was defined as a medical sub-discipline; consolidation, 1920-1945, with the institutionalisation of psychiatric care, and with psychoanalysis and mental hygiene as qualitatively new cognitive bases for practitioners; and professionalisation, 1945-1980, with the deinstitutionalisation of psychiatric care and the professionalisation of psychologists and social workers. New ideas on subjectivity and individualism, new welfare state institutions, as well as collaborative professionalism all favoured the creation of psychotherapy as professional knowledge, and a possible new profession of psychotherapists.

  4. Factors Influencing Registered Nurses' Perceptions of Their Professional Identity: An Integrative Literature Review.

    Science.gov (United States)

    Rasmussen, Philippa; Henderson, Ann; Andrew, Nicky; Conroy, Tiffany

    2018-05-01

    This review synthesizes contemporary research investigating the factors influencing RNs' perceptions of their professional identity. The method used was an integrative literature review. Factors influencing RNs' perceptions of their professional identity were synthesized into three categories: the self, the role, and the context. The self is the nurse who enacts the role in practice, and the context is the practice setting. Poor alignment of these categories leads to stress, tension, and uncertainty affecting work-force retention. Strong alignment leads to satisfaction with the nursing role, increased staff retention, and improved quality of care and patient outcomes. These three categories should be considered when planning nursing professional development activities. This integrative review identified a lack of research addressing how nurses' perceptions of their professional identity change over time. A deeper understanding of their perspective is needed to establish whether career longevity and continued professional development are influences. J Contin Educ Nurs. 2018;49(5):225-232. Copyright 2018, SLACK Incorporated.

  5. Job Characteristics and Pressures and the Organizational Integration of Professionals

    Science.gov (United States)

    Hall, Douglas T.; Lawler, Edward E.

    1970-01-01

    Focuses on the relationship between job design and the integration of the professional with his organization; the concept of job pressures is used as an intervening variable in the study of his relationship. (Author)

  6. Extended depth of field integral imaging using multi-focus fusion

    Science.gov (United States)

    Piao, Yongri; Zhang, Miao; Wang, Xiaohui; Li, Peihua

    2018-03-01

    In this paper, we propose a new method for depth of field extension in integral imaging by realizing the image fusion method on the multi-focus elemental images. In the proposed method, a camera is translated on a 2D grid to take multi-focus elemental images by sweeping the focus plane across the scene. Simply applying an image fusion method on the elemental images holding rich parallax information does not work effectively because registration accuracy of images is the prerequisite for image fusion. To solve this problem an elemental image generalization method is proposed. The aim of this generalization process is to geometrically align the objects in all elemental images so that the correct regions of multi-focus elemental images can be exacted. The all-in focus elemental images are then generated by fusing the generalized elemental images using the block based fusion method. The experimental results demonstrate that the depth of field of synthetic aperture integral imaging system has been extended by realizing the generation method combined with the image fusion on multi-focus elemental images in synthetic aperture integral imaging system.

  7. Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the Design and Operation of Multi-center Clinical Trials: a Qualitative Research Study

    OpenAIRE

    Eisenstein, Eric L.; Diener, Lawrence W.; Nahm, Meredith; Weinfurt, Kevin P.

    2010-01-01

    New technologies may be required to integrate the National Institutes of Health’s Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators ...

  8. Design of Smart Multi-Functional Integrated Aviation Photoelectric Payload

    Science.gov (United States)

    Zhang, X.

    2018-04-01

    To coordinate with the small UAV at reconnaissance mission, we've developed a smart multi-functional integrated aviation photoelectric payload. The payload weighs only 1kg, and has a two-axis stabilized platform with visible task payload, infrared task payload, laser pointers and video tracker. The photoelectric payload could complete the reconnaissance tasks above the target area (including visible and infrared). Because of its light weight, small size, full-featured, high integrated, the constraints of the UAV platform carrying the payload will be reduced a lot, which helps the payload suit for more extensive using occasions. So all users of this type of smart multi-functional integrated aviation photoelectric payload will do better works on completion of the ground to better pinpoint targets, artillery calibration, assessment of observe strike damage, customs officials and other tasks.

  9. Professional Use of Social Media Among Surgeons: Results of a Multi-Institutional Study.

    Science.gov (United States)

    Wagner, Justin P; Cochran, Amalia L; Jones, Christian; Gusani, Niraj J; Varghese, Thomas K; Attai, Deanna J

    2017-09-27

    Among surgeons, professional use of social media (SM) is varied, and attitudes are ambiguous. We sought to characterize surgeons' professional use and perceptions of SM. Surgical faculty and trainees received institutional review board-approved e-mail surveys assessing SM usage and attitudes. Regression analyses identified predictors of SM attitudes and preference for professional contact. Surveys were administered to surgical faculty, fellows, and residents at 4 academic medical centers between January and April 2016. Of 1037 surgeons, clinical fellows, and residents e-mailed, 208 (20%) responded, including 132 faculty and 76 trainees. Among 208 respondents, 46 (22%) indicated they preferred some form of SM as their preferred networking and communication modality. A total of 145 (70%) indicated they believe SM benefits professional development. The position of clinical resident predicted preference to maintain professional contact via SM (p = 0.03). Age professional purposes. Perceived barriers include lack of value, time constraints, and personal and patient privacy concerns. Generational differences in surgeon attitudes suggest usage of SM among surgeons will expand over time. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  10. Revisioning Clinical Psychology: Integrating Cultural Psychology into Clinical Research and Practice with Portuguese Immigrants

    Science.gov (United States)

    James, Susan; Harris, Sara; Foster, Gary; Clarke, Juanne; Gadermann, Anne; Morrison, Marie; Bezanson, Birdie Jane

    2013-01-01

    This article outlines a model for conducting psychotherapy with people of diverse cultural backgrounds. The theoretical foundation for the model is based on clinical and cultural psychology. Cultural psychology integrates psychology and anthropology in order to provide a complex understanding of both culture and the individual within his or her cultural context. The model proposed in this article is also based on our clinical experience and mixed-method research with the Portuguese community. The model demonstrates its value with ethnic minority clients by situating the clients within the context of their multi-layered social reality. The individual, familial, socio-cultural, and religio-moral domains are explored in two research projects, revealing the interrelation of these levels/contexts. The article is structured according to these domains. Study 1 is a quantitative study that validates the Agonias Questionnaire in Ontario. The results of this study are used to illustrate the individual domain of our proposed model. Study 2 is an ethnography conducted in the Azorean Islands, and the results of this study are integrated to illustrate the other three levels of the model, namely family, socio-cultural, and the religio-moral levels. PMID:23720642

  11. Attitudes toward suicidal behaviour among professionals at mental health outpatient clinics in Stavropol, Russia and Oslo, Norway.

    Science.gov (United States)

    Norheim, Astrid Berge; Grimholt, Tine K; Loskutova, Ekaterina; Ekeberg, Oivind

    2016-07-27

    Attitudes toward suicidal behaviour can be essential regarding whether patients seek or are offered help. Patients with suicidal behaviour are increasingly treated by mental health outpatient clinics. Our aim was to study attitudes among professionals at outpatient clinics in Stavropol, Russia and Oslo, Norway. Three hundred and forty-eight (82 %) professionals anonymously completed a questionnaire about attitudes. Professionals at outpatient clinics in Stavropol (n = 119; 94 %) and Oslo (n = 229; 77 %) were enrolled in the study. The Understanding Suicidal Patients (USP) scale (11 = positive to 55 = negative) and the Attitudes Towards Suicide Scale (ATTS) (1 = totally disagree, 5 = totally agree) were used. Questions about religious background, perceived competence and experiences of and views on suicidal behaviour and treatment (0 = totally disagree, 4 = totally agree) were examined. All groups reported positive attitudes, with significant differences between Stavropol and Oslo (USP score, 21.8 vs 18.7; p attitudes towards helping suicidal patients, with significant differences between cities. A need for further education was reported in both cities, but education was less integrated in mental health care in Stavropol than it was in Oslo. In both cities, psychiatric disorders were considered the major reasons for suicide, and psychotherapy was the most important treatment measure.

  12. The development of integrated service centre system for professional teachers empowerment in North Sumatera

    Science.gov (United States)

    Gultom, S.; Simanjorang, M. M.; Muchtar, Z.; Mansyur, A.

    2018-03-01

    Based on Act number 12 in year 2012 the function of higher education is related to individual, social community, knowledge and technology development. Hence, higher education providers need to think and develop policies in order to improve their service and fulfil the higher education function. As part of the effort to fulfil its function Universitas Negeri Medan (Unimed), which historically was a pre-service teacher training institute, should has a special interest on improving teachers’ professionalism. The Act number 14 in year 2005 described requirements for professional teacher, including academic qualification and set of competencies possessed by the teacher. The Act also guaranties teachers’ right to have opportunities for improving their competencies and academic qualification through training and other professionalism development programme. The question is how this guarantee can be implemented. In order to answer this question a developmental study has been done which aimed on developing an integrated service centre system for professional teachers empowerment. As the name implies, this integrated service centre system is expected to be a real manifestation of Unimed’s support towards the improvement of professional teachers quality, which in the end will boils down to the improvement of national education services quality. The result of this study is an integrated service centre system for professional teachers empowerment that fulfils the professionalism principles described in the Act number 14 in year 2005, which has been developed by considering problems faced by and also supports needed by teachers post certification programme.

  13. Effectiveness of faculty training to enhance clinical evaluation of student competence in ethical reasoning and professionalism.

    Science.gov (United States)

    Christie, Carole; Bowen, Denise; Paarmann, Carlene

    2007-08-01

    This study evaluated the short- and long-term effectiveness of faculty training to enhance clinical evaluation of ethical reasoning and professionalism in a baccalaureate dental hygiene program. Ethics, values, and professionalism are best measured in contexts comparable to practice; therefore, authentic evaluation is desirable for assessing these areas of competence. Methods were the following: 1) a faculty development workshop implementing a core values-based clinical evaluation system for assessing students' professional judgment; 2) subsequent evaluation of the clinical faculty's use of core values for grading and providing written comments related to students' professional judgment during patient care for three academic years; and 3) evaluation of program outcomes assessments regarding clinical learning experiences related to ethics and professionalism domains. Results revealed the clinical faculty's evaluation of professional judgment during patient care was enhanced by training; written comments more frequently related to core values defined in the American Dental Hygienists' Association (ADHA) Code of Ethics; and faculty members reported more confidence and comfort evaluating professional judgment after implementation of this evaluation system and receiving training in its application. Students were more positive in outcomes assessments about their competency and learning experiences related to professionalism and ethics. This article shares one approach for enhancing clinical faculty's authentic evaluation of student competence in ethical reasoning and professionalism.

  14. Research on Multi - Person Parallel Modeling Method Based on Integrated Model Persistent Storage

    Science.gov (United States)

    Qu, MingCheng; Wu, XiangHu; Tao, YongChao; Liu, Ying

    2018-03-01

    This paper mainly studies the multi-person parallel modeling method based on the integrated model persistence storage. The integrated model refers to a set of MDDT modeling graphics system, which can carry out multi-angle, multi-level and multi-stage description of aerospace general embedded software. Persistent storage refers to converting the data model in memory into a storage model and converting the storage model into a data model in memory, where the data model refers to the object model and the storage model is a binary stream. And multi-person parallel modeling refers to the need for multi-person collaboration, the role of separation, and even real-time remote synchronization modeling.

  15. A Multi-Actor Dynamic Integrated Assessment Model (MADIAM)

    OpenAIRE

    Weber, Michael

    2004-01-01

    The interactions between climate and the socio-economic system are investigated with a Multi-Actor Dynamic Integrated Assessment Model (MADIAM) obtained by coupling a nonlinear impulse response model of the climate sub-system (NICCS) to a multi-actor dynamic economic model (MADEM). The main goal is to initiate a model development that is able to treat the dynamics of the coupled climate socio-economic system, including endogenous technological change, in a non-equilibrium situation, thereby o...

  16. Development of a formative assessment tool for measurement of performance in multi-professional resuscitation teams

    DEFF Research Database (Denmark)

    Andersen, Peter Oluf; Jensen, Michael Kammer; Lippert, Anne

    2010-01-01

    a part of crew resource management training, created to improve safety in aviation. This study aimed, first, to establish crew resource management and non-technical skill-based learning objectives and behavioural markers for the performance of multi-professional resuscitation teams; second, to develop...

  17. Integration of Professional Certification Examinations with the Financial Planning Curriculum: Increasing Efficiency, Motivation, and Professional Success

    Science.gov (United States)

    Goetz, Joseph W.; Zhu, Dandan; Hampton, Vickie L.; Chatterjee, Swarn; Salter, John

    2011-01-01

    This article provides a theoretical-based rationale and plan of action for educational programs to encourage and create opportunities for the integration of course study with professional exam preparation, while highlighting the complementary benefits for students, academic programs, and the financial services profession. Serving primarily as a…

  18. Empathic concern and professional characteristics associated with clinical empathy in French general practitioners.

    Science.gov (United States)

    Lelorain, Sophie; Sultan, Serge; Zenasni, Franck; Catu-Pinault, Annie; Jaury, Philippe; Boujut, Emilie; Rigal, Laurent

    2013-03-01

    Clinical empathy, i.e. the ability of physicians to adopt patient perspective, is an essential component of care, which depends in part on empathic concern, i.e. compassionate emotions felt for others. However, too much empathic concern can be challenging for physicians. Aim of this study was to examine physician practice characteristics that could explain clinical empathy beyond empathic concern. We were also interested in testing whether professional reflective activities, such as Balint group attendance or clinical supervision, might make clinical empathy less dependent on empathic concern. A total of 295 French general practitioners (response rate of 37%) completed self-reported questionnaires on empathic concern and clinical empathy, using the Toronto empathy questionnaire (TEQ) and the Jefferson scale of physician empathy (JSPE), respectively. We also recorded information on their professional practice: professional experience, duration of consultations, and participation in Balint groups or being a clinical supervisor. Hierarchical regression analyses were carried out with clinical empathy as dependent variable. Empathic concern was an important component of clinical empathy variance. The physician practice characteristics 'consultation length' and 'being a Balint attendee or a supervisor,' but not 'clinical experience' made a significant and unique contribution to clinical empathy beyond that of empathic concern. Participating to one reflective activity (either Balint group attendance or clinical supervision) made clinical empathy less dependent on empathic concern. Working conditions such as having enough consultation time and having the opportunity to attend a professional reflective activity support the maintenance of clinical empathy without the burden of too much empathic concern.

  19. Depression and suicide risk among nursing professionals: an integrative review

    Directory of Open Access Journals (Sweden)

    Darlan dos Santos Damásio Silva

    2015-12-01

    Full Text Available Abstract OBJECTIVE Discussing the factors associated with major depression and suicide risk among nursing professionals. METHOD An integrative review in PubMed/MEDLINE, LILACS, SciELO and BDENF databases, between 2003 and 2015. RESULTS 20 published articles were selected, mostly from between 2012 and 2014, with significant production in Brazil. Nursing professionals are vulnerable to depression when young, married, performing night work and having several jobs, and when they have a high level of education, low family income, work overload, high stress, insufficient autonomy and a sense of professional insecurity and conflict in the family and workrelationship. Suicide risk was correlated with the presence of symptoms of depression, high levels of emotional exhaustion, depersonalization and low personal accomplishment; characteristics of Burnout Syndrome. CONCLUSION Suicide risk among nursing professionals is associated with symptoms of depression and correlated with Burnout Syndrome, which can affect work performance.

  20. Integrating Compassionate, Collaborative Care (the "Triple C") Into Health Professional Education to Advance the Triple Aim of Health Care.

    Science.gov (United States)

    Lown, Beth A; McIntosh, Sharrie; Gaines, Martha E; McGuinn, Kathy; Hatem, David S

    2016-03-01

    Empathy and compassion provide an important foundation for effective collaboration in health care. Compassion (the recognition of and response to the distress and suffering of others) should be consistently offered by health care professionals to patients, families, staff, and one another. However, compassion without collaboration may result in uncoordinated care, while collaboration without compassion may result in technically correct but depersonalized care that fails to meet the unique emotional and psychosocial needs of all involved. Providing compassionate, collaborative care (CCC) is critical to achieving the "triple aim" of improving patients' health and experiences of care while reducing costs. Yet, values and skills related to CCC (or the "Triple C") are not routinely taught, modeled, and assessed across the continuum of learning and practice. To change this paradigm, an interprofessional group of experts recently recommended approaches and a framework for integrating CCC into health professional education and postgraduate training as well as clinical care. In this Perspective, the authors describe how the Triple C framework can be integrated and enhance existing competency standards to advance CCC across the learning and practice continuum. They also discuss strategies for partnering with patients and families to improve health professional education and health care design and delivery through quality improvement projects. They emphasize that compassion and collaboration are important sources of professional, patient, and family satisfaction as well as critical aspects of professionalism and person-centered, relationship-based high-quality care.

  1. [Clinical safety and professional liability claims in Orthopaedic Surgery and Traumatology].

    Science.gov (United States)

    Bori, G; Gómez-Durán, E L; Combalia, A; Trilla, A; Prat, A; Bruguera, M; Arimany-Manso, J

    2016-01-01

    The specialist in orthopaedic and traumatological surgery, like any other doctor, is subject to the current legal provisions while exercising their profession. Mandatory training in the medical-legal aspects of health care is essential. Claims against doctors are a reality, and orthopaedic and traumatological surgery holds first place in terms of frequency of claims according to the data from the General Council of Official Colleges of Doctors of Catalonia. Professionals must be aware of the fundamental aspects of medical professional liability, as well as specific aspects, such as defensive medicine and clinical safety. The understanding of these medical-legal aspects in the routine clinical practice can help to pave the way towards a satisfactory and safe professional career. The aim of this review is to contribute to this training, for the benefit of professionals and patients. Copyright © 2015 SECOT. Published by Elsevier Espana. All rights reserved.

  2. Clinical trials integrity: a CRO perspective.

    Science.gov (United States)

    Beach, J E

    2001-01-01

    When contract research organizations (CROs) were first formed, pharmaceutical companies outsourced to them only certain aspects of the conduct of their clinical trials. At first CROs were highly specialized entities, providing, for example, either biostatistical advice, clinical research associates who monitored investigational sites for regulatory compliance, or regulatory support. Gradually, full service CROs emerged, offering a full range of services for clinical trials, including the selection of investigators and investigational sites, assistance with patient recruitment, safety surveillance and reporting, site audits, and data management and biostatistics. This evolving relationship between CROs and the pharmaceutical and medical device industries has resulted in CROs assuming more and more of the regulatory and ethical risks and responsibilities inherent in the conduct of clinical trials. In this full service role, CROs, unlike sponsors, are not interested in the outcome of study, but like sponsors, are subject to heavy regulation by the federal government, must follow applicable state laws, must respect international guidelines, and are obliged to follow their own operating procedures. Moreover, they are judged by the industry on the basis of the scope and quality of services provided, including the degree of adherence to the research protocol, regulatory requirements, and timelines; the quality of the professional working relationships with investigators and institutions, both academic and community-based; and the validity of the data. Further, CROs are subject to comprehensive audits by sponsoring companies, FDA, and other regulatory authorities. For all these reasons, CROs are being tasked with strict vigilance of all stages of the clinical trial process to ensure that the laws, regulations, and industry standards designed for the protection of human subjects and data integrity are maintained.

  3. Emergency Medicine Resident Perceptions of Medical Professionalism

    Directory of Open Access Journals (Sweden)

    Joshua Jauregui

    2016-05-01

    Full Text Available Introduction: Medical professionalism is a core competency for emergency medicine (EM trainees; but defining professionalism remains challenging, leading to difficulties creating objectives and performing assessment. Because professionalism is dynamic, culture-specific, and often taught by modeling, an exploration of trainees’ perceptions can highlight their educational baseline and elucidate the importance they place on general conventional professionalism domains. To this end, our objective was to assess the relative value EM residents place on traditional components of professionalism. Methods: We performed a cross-sectional, multi-institutional survey of incoming and graduating EM residents at four programs. The survey was developed using the American Board of Internal Medicine’s “Project Professionalism” and the Accreditation Council of Graduate Medical Education definition of professionalism competency. We identified 27 attributes within seven domains: clinical excellence, humanism, accountability, altruism, duty and service, honor and integrity, and respect for others. Residents were asked to rate each attribute on a 10-point scale. We analyzed data to assess variance across attributes as well as differences between residents at different training levels or different institutions. Results: Of the 114 residents eligible, 100 (88% completed the survey. The relative value assigned to different professional attributes varied considerably, with those in the altruism domain valued significantly lower and those in the “respect for others” and “honor and integrity” valued significantly higher (p<0.001. Significant differences were found between interns and seniors for five attributes primarily in the “duty and service” domain (p<0.05. Among different residencies, significant differences were found with attributes within the “altruism” and “duty and service” domains (p<0.05. Conclusion: Residents perceive differences in

  4. Promoting integrity in the workplace: a priority for all academic health professionals.

    Science.gov (United States)

    Cleary, Michelle; Walter, Garry; Horsfall, Jan; Jackson, Debra

    2013-10-01

    The performance-driven culture of universities challenges faculty to meet workplace expectations. In this paper, we draw on the literature to identify key aspects of, and requirements for, promoting integrity in the academic workplace. Integrity is a crucial personal characteristic that can exert a powerful influence in any setting. Any threat to integrity in the workplace can result in a toxic and corrupt environment that may be deleterious to faculty and students. Such an environment can act to prevent faculty from speaking up about ethical issues or workplace concerns, which can result in failure to identify areas for improvement, continuation of suboptimal practices, and problematic professional relationships. The aim of this paper, therefore, is to present an overview of the concept of integrity in the academic workforce and to discuss some of the issues and dimensions, in the hope of creating greater awareness. This is essential if health professional faculties are to recruit and retain staff and create optimal working environments conducive to facilitating high quality outcomes.

  5. Integrating clinical communication with clinical reasoning and the broader medical curriculum.

    Science.gov (United States)

    Cary, Julie; Kurtz, Suzanne

    2013-09-01

    The objectives of this paper are to discuss the results of a workshop conducted at EACH 2012. Specifically, we will (1) examine the link between communication, clinical reasoning, and medical problem solving, (2) explore strategies for (a) integrating clinical reasoning, medical problem solving, and content from the broader curriculum into clinical communication teaching and (b) integrating communication into the broader curriculum, and (3) discuss benefits gained from such integration. Salient features from the workshop were recorded and will be presented here, as well as a case example to illustrate important connections between clinical communication and clinical reasoning. Potential links between clinical communication, clinical reasoning, and medical problem solving as well as strategies to integrate clinical communication teaching and the broader curricula in human and veterinary medicine are enumerated. Participants expressed enthusiasm and keen interest in integration of clinical communication teaching and clinical reasoning during this workshop, came to the idea of the interdependence of these skills easily, and embraced the rationale immediately. Valuing the importance of communication as clinical skill and embracing the interdependence between communication and thought processes related to clinical reasoning and medical problem solving will be beneficial in teaching programs. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  6. Altruism in clinical research: coordinators' orientation to their professional roles.

    Science.gov (United States)

    Fisher, Jill A; Kalbaugh, Corey A

    2012-01-01

    Research coordinators have significant responsibilities in clinical trials that often require them to find unique ways to manage their jobs, thus reshaping their professional identities. The purpose of this study was to identify how research coordinators manage role and ethical conflicts within clinical research trials. A qualitative study combining observation and 63 semistructured interviews at 25 research organizations was used. Altruism is a recurring theme in how research coordinators define and view their work. Altruism is adopted by research coordinators to: (1) Teach patient-subjects the appropriate reasons to participate in clinical research, (2) minimize the conflict between research and care, and (3) contest the undervaluation of coordinating. Altruism is a strategy used to handle the various conflicts they experience in a difficult job, and it has become part of the professional identity of clinical research coordinators. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Professional impact of clinical research

    Energy Technology Data Exchange (ETDEWEB)

    Nelhans, G.

    2016-07-01

    In this study, professional impact is defined as the academic literature that is cited in the literature that is used by professions in order to pursue skilled activities that are specific to their expertise. Specifically, we are focusing on the clinical guidelines that are used in the many health and medical professions that are issued by government bodies at national and international levels to ensure a certain quality level and to make results comparable at the national level. To date, more than 50.000 references have been identified in about 500 Swedish clinical guidelines issued by the above mentioned governmental bodies in Sweden. Of these, 73 % of the references have been matched to a PubMed id. The goal of this project is to develop a conceptual and theoretical contribution to the development of indicators for measuring the impact of research outside of the specifically academic literature. (Author)

  8. Professional Development Recognizing Technology Integration Modeled after the TPACK Framework

    Science.gov (United States)

    McCusker, Laura

    2017-01-01

    Public school teachers within a Pennsylvania intermediate unit are receiving inadequate job-embedded professional development that recognizes knowledge of content, pedagogy, and technology integration, as outlined by Mishra and Koehler's Technological Pedagogical Content Knowledge (TPACK) framework (2006). A school environment where teachers are…

  9. Integration of multi-technology on oil spill emergency preparedness.

    Science.gov (United States)

    Liao, Zhenliang; Hannam, Phillip M; Xia, Xiaowei; Zhao, Tingting

    2012-10-01

    This paper focuses on the integration of technologies including Case-Based Reasoning (CBR), Genetic Algorithm (GA) and Artificial Neural Network (ANN) for establishing emergency preparedness for oil spill accidents. In CBR, the Frame method is used to define case representation, and the HEOM (Heterogeneous Euclidean-Overlap Metric) is improved to define the similarity of case properties. In GA, we introduce an Improved Genetic Algorithm (IGA) that achieves case adaptation, in which technologies include the Multi-Parameter Cascade Code method, the Small Section method for generation of an initial population, the Multi-Factor Integrated Fitness Function, and Niche technology for genetic operations including selection, crossover, and mutation. In ANN, a modified back-propagation algorithm is employed to train the algorithm to quickly improve system preparedness. Through the analysis of 32 fabricated oil spill cases, an oil spill emergency preparedness system based on the integration of CBR, GA and ANN is introduced. In particular, the development of ANN is presented and analyzed. The paper also discusses the efficacy of our integration approach. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Identification of multi-drug resistant Pseudomonas aeruginosa clinical isolates that are highly disruptive to the intestinal epithelial barrier

    Directory of Open Access Journals (Sweden)

    Shevchenko Olga

    2006-06-01

    Full Text Available Abstract Background Multi-drug resistant Pseudomonas aeruginosa nosocomial infections are increasingly recognized worldwide. In this study, we focused on the virulence of multi-drug resistant clinical strains P. aeruginosa against the intestinal epithelial barrier, since P. aeruginosa can cause lethal sepsis from within the intestinal tract of critically ill and immuno-compromised patients via mechanisms involving disruption of epithelial barrier function. Methods We screened consecutively isolated multi-drug resistant P. aeruginosa clinical strains for their ability to disrupt the integrity of human cultured intestinal epithelial cells (Caco-2 and correlated these finding to related virulence phenotypes such as adhesiveness, motility, biofilm formation, and cytotoxicity. Results Results demonstrated that the majority of the multi-drug resistant P. aeruginosa clinical strains were attenuated in their ability to disrupt the barrier function of cultured intestinal epithelial cells. Three distinct genotypes were found that displayed an extreme epithelial barrier-disrupting phenotype. These strains were characterized and found to harbor the exoU gene and to display high swimming motility and adhesiveness. Conclusion These data suggest that detailed phenotypic analysis of the behavior of multi-drug resistant P. aeruginosa against the intestinal epithelium has the potential to identify strains most likely to place patients at risk for lethal gut-derived sepsis. Surveillance of colonizing strains of P. aeruginosa in critically ill patients beyond antibiotic sensitivity is warranted.

  11. A multi-instructor, team-based, active-learning exercise to integrate basic and clinical sciences content.

    Science.gov (United States)

    Kolluru, Srikanth; Roesch, Darren M; Akhtar de la Fuente, Ayesha

    2012-03-12

    To introduce a multiple-instructor, team-based, active-learning exercise to promote the integration of basic sciences (pathophysiology, pharmacology, and medicinal chemistry) and clinical sciences in a doctor of pharmacy curriculum. A team-based learning activity that involved pre-class reading assignments, individual-and team-answered multiple-choice questions, and evaluation and discussion of a clinical case, was designed, implemented, and moderated by 3 faculty members from the pharmaceutical sciences and pharmacy practice departments. Student performance was assessed using a multiple-choice examination, an individual readiness assurance test (IRAT), a team readiness assurance test (TRAT), and a subjective, objective, assessment, and plan (SOAP) note. Student attitudes were assessed using a pre- and post-exercise survey instrument. Students' understanding of possible correct treatment strategies for depression improved. Students were appreciative of this true integration of basic sciences knowledge in a pharmacotherapy course and to have faculty members from both disciplines present to answer questions. Mean student score on the on depression module for the examination was 80.4%, indicating mastery of the content. An exercise led by multiple instructors improved student perceptions of the importance of team-based teaching. Integrated teaching and learning may be achieved when instructors from multiple disciplines work together in the classroom using proven team-based, active-learning exercises.

  12. Screening for depression: integrating training into the professional development programme for low vision rehabilitation staff.

    Science.gov (United States)

    Rees, Gwyneth; Holloway, Edith E; Craig, Graeme; Hepi, Niky; Coad, Samantha; Keeffe, Jill E; Lamoureux, Ecosse L

    2012-12-01

    To describe the integration of depression screening training into the professional development programme for low vision rehabilitation staff and report on staff evaluation of this training. Pre-post intervention study, in a single population of low vision rehabilitation staff. Three hundred and thirty-six staff from Australia's largest low vision rehabilitation organization, Vision Australia. Staff completed the depression screening and referral training as part of a wider professional development programme. A pre-post-training questionnaire was administered to all staff. Descriptive and non-parametric statistics were used to determine differences in self-reported knowledge, confidence, barriers to recognition and management of depression between baseline and post training. One hundred and seventy-two participants completed both questionnaires. Following training, participants reported an increased knowledge of depression, were more likely to respond to depression in their clients and reported to be more confident in managing depression (P training incorporating more active and 'hands-on' sessions are likely to be required. This training is a promising first step in integrating a depression screening tool into low vision rehabilitation practice. Further work is needed to determine the barriers and facilitators to implementation in practice and to assess clients' acceptability and outcomes. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.

  13. CLINICAL SURFACES - Activity-Based Computing for Distributed Multi-Display Environments in Hospitals

    Science.gov (United States)

    Bardram, Jakob E.; Bunde-Pedersen, Jonathan; Doryab, Afsaneh; Sørensen, Steffen

    A multi-display environment (MDE) is made up of co-located and networked personal and public devices that form an integrated workspace enabling co-located group work. Traditionally, MDEs have, however, mainly been designed to support a single “smart room”, and have had little sense of the tasks and activities that the MDE is being used for. This paper presents a novel approach to support activity-based computing in distributed MDEs, where displays are physically distributed across a large building. CLINICAL SURFACES was designed for clinical work in hospitals, and enables context-sensitive retrieval and browsing of patient data on public displays. We present the design and implementation of CLINICAL SURFACES, and report from an evaluation of the system at a large hospital. The evaluation shows that using distributed public displays to support activity-based computing inside a hospital is very useful for clinical work, and that the apparent contradiction between maintaining privacy of medical data in a public display environment can be mitigated by the use of CLINICAL SURFACES.

  14. A Bidirectional Multi-Port DC-DC Converter Integrating Voltage Equalizer

    DEFF Research Database (Denmark)

    Chen, Jianfei; Hou, Shiying; Deng, Fujin

    2015-01-01

    A novel bidirectional multi-port dc-dc converter integrating voltage equalizer based on switched-capacitor voltage accumulator (SCVA) is proposed. It has two operating modes of charging and discharging for battery modules. All battery modules are connected in series indirectly and can be equalize...... battery modules with different voltages. Simulation results has shown the feasibility of the proposed converter.......A novel bidirectional multi-port dc-dc converter integrating voltage equalizer based on switched-capacitor voltage accumulator (SCVA) is proposed. It has two operating modes of charging and discharging for battery modules. All battery modules are connected in series indirectly and can be equalized...

  15. Signal integrity applied electromagnetics and professional practice

    CERN Document Server

    Russ, Samuel H

    2016-01-01

    This textbook teaches how to design working systems at very high frequencies. It is designed to introduce computer engineers to the design of extremely high speed digital systems. Combining an intuitive, physics-based approach to electromagnetics with a focus on solving realistic problems, the author presents concepts that are essential for computer and electrical engineers today. The book emphasizes an intuitive approach to electromagnetics, and then uses this foundation to show the reader how both physical phenomena can cause signals to propagate incorrectly; and how to solve commonly encountered issues. Emphasis is placed on real problems that the author has encountered in his professional career, integrating problem-solving strategies and real signal-integrity case studies throughout the presentation. Students are challenged to think about managing complex design projects and implementing successful engineering and manufacturing processes. Each chapter includes exercises to test concepts introduced.

  16. Factors affecting knowledge transfer from continuing professional education to clinical practice: Development and psychometric properties of a new instrument.

    Science.gov (United States)

    Vasli, Parvaneh; Dehghan-Nayeri, Nahid; Khosravi, Laleh

    2018-01-01

    Despite the emphasis placed on the implementation of continuing professional education programs in Iran, researchers or practitioners have not developed an instrument for assessing the factors that affect the knowledge transfer from such programs to clinical practice. The aim of this study was to design and validate such instrument for the Iranian context. The research used a three-stage mix method. In the first stage, in-depth interviews with nurses and content analysis were conducted, after which themes were extracted from the data. In the second stage, the findings of the content analysis and literature review were examined, and preliminary instrument options were developed. In the third stage, qualitative content validity, face validity, content validity ratio, content validity index, and construct validity using exploratory factor analysis was conducted. The reliability of the instrument was measured before and after the determination of construct validity. Primary tool instrument initially comprised 53 items, and its content validity index was 0.86. In the multi-stage factor analysis, eight questions were excluded, thereby reducing 11 factors to five and finally, to four. The final instrument with 43 items consists of the following dimensions: structure and organizational climate, personal characteristics, nature and status of professionals, and nature of educational programs. Managers can use the Iranian instrument to identify factors affecting knowledge transfer of continuing professional education to clinical practice. Copyright © 2017. Published by Elsevier Ltd.

  17. Narrative in interprofessional education and practice: implications for professional identity, provider-patient communication and teamwork.

    Science.gov (United States)

    Clark, Phillip G

    2014-01-01

    Health and social care professionals increasingly use narrative approaches to focus on the patient and to communicate with each other. Both effective interprofessional education (IPE) and practice (IPP) require recognizing the various values and voices of different professions, how they relate to the patient's life story, and how they interact with each other at the level of the healthcare team. This article analyzes and integrates the literature on narrative to explore: self-narrative as an expression of one's professional identity; the co-creation of the patient's narrative by the professional and the patient; and the interprofessional multi-vocal narrative discourse as co-constructed by members of the healthcare team. Using a narrative approach to thinking about professional identity, provider-patient communication, and interprofessional teamwork expands our thinking about both IPE and IPP by providing new insights into the nature of professional practice based on relationships to oneself, the patient, and others on the team. How professionals define themselves, gather and present information from the patient, and communicate as members of a clinical team all have important dimensions that can be revealed by a narrative approach. Implications and conclusions for the further development of the narrative approach in IPE and IPP are offered.

  18. Integrating Poverty and Gender into Health Programs: A Sourcebook for Health Professionals.

    Science.gov (United States)

    Coll-Black, Sarah; Bhushan, Anjana; Fritsch, Kathleen

    2007-12-01

    Evidence increasingly shows that poverty and gender inequalities are important determinants of health and influence the opportunity for timely and appropriate health care. These findings suggest that health professionals need to have a sound understanding of health inequalities and their causes, as well as of how they can be addressed. However, through surveys to health ministries and educational institutions in 2001, the World Health Organization Regional Office for the Western Pacific found that awareness of, and capacity to respond to, poverty and gender concerns in health was weak. In response, the Regional Office initiated a project to develop materials to support the integration of poverty and gender concerns into health professional education curricula. The multimodule publication, Integrating Poverty and Gender into Health Programmes: A Sourcebook for Health Professionals, supports evidence-based and participatory learning. The experience to date suggests that the publication might be meeting a long-felt need for such a response.

  19. Multi-target electrochemical biosensing enabled by integrated CMOS electronics

    International Nuclear Information System (INIS)

    Rothe, J; Lewandowska, M K; Heer, F; Frey, O; Hierlemann, A

    2011-01-01

    An integrated electrochemical measurement system, based on CMOS technology, is presented, which allows the detection of several analytes in parallel (multi-analyte) and enables simultaneous monitoring at different locations (multi-site). The system comprises a 576-electrode CMOS sensor chip, an FPGA module for chip control and data processing, and the measurement laptop. The advantages of the highly versatile system are demonstrated by two applications. First, a label-free, hybridization-based DNA sensor is enabled by the possibility of large-scale integration in CMOS technology. Second, the detection of the neurotransmitter choline is presented by assembling the chip with biosensor microprobe arrays. The low noise level enables a limit of detection of, e.g., 0.3 µM choline. The fully integrated system is self-contained: it features cleaning, functionalization and measurement functions without the need for additional electrical equipment. With the power supplied by the laptop, the system is very suitable for on-site measurements

  20. Personalized precision radiotherapy by integration of multi-parametric functional and biological imaging in prostate cancer. A feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Thorwarth, Daniela [Tuebingen Univ. (Germany). Section for Biomedical Physics; Notohamiprodjo, Mike [Tuebingen Univ. (Germany). Dept. of Diagnostic and Interventional Radiology; Zips, Daniel; Mueller, Arndt-Christan [Tuebingen Univ. (Germany). Dept. of Radiation Oncology

    2017-05-01

    To increase tumour control probability (TCP) in prostate cancer a method was developed integrating multi-parametric functional and biological information into a dose painting treatment plan aiming focal dose-escalation to tumour sub-volumes. A dose-escalation map was derived considering individual, multi-parametric estimated tumour aggressiveness. Multi-parametric functional imaging (MRI, Choline-/PSMA-/FMISO-PET/CT) was acquired for a high risk prostate cancer patient with a high level of tumour load (cT3b cN0 cM0) indicated by subtotal involvement of prostate including the right seminal vesicle and by PSA-level >100. Probability of tumour presence was determined by a combination of multi-parametric functional image information resulting in a voxel-based map of tumour aggressiveness. This probability map was directly integrated into dose optimization in order to plan for inhomogeneous, biological imaging based dose painting. Histograms of the multi-parametric prescription function were generated in addition to a differential histogram of the planned inhomogeneous doses. Comparison of prescribed doses with planned doses on a voxel level was realized using an effective DVH, containing the ratio of prescribed vs. planned dose for each tumour voxel. Multi-parametric imaging data of PSMA, Choline and FMISO PET/CT as well as ADC maps derived from diffusion weighted MRI were combined to an individual probability map of tumour presence. Voxel-based prescription doses ranged from 75.3 Gy up to 93.4 Gy (median: 79.6 Gy), whereas the planned dose painting doses varied only between 72.5 and 80.0 Gy with a median dose of 75.7 Gy. However, inhomogeneous voxel-based dose prescriptions can only be implemented into a treatment plan until a certain level. Multi-parametric probability based dose painting in prostate cancer is technically and clinically feasible. However, detailed calibration functions to define the necessary probability functions need to be assessed in future

  1. Collaborative Teaching and Learning through Multi-Institutional Integrated Group Projects

    Science.gov (United States)

    Long, Suzanna K.; Carlo, Héctor J.

    2013-01-01

    This teaching brief describes an innovative multi-institutional initiative through which integrated student groups from different courses collaborate on a common course project. In this integrated group project, students are asked to design a decentralized manufacturing organization for a company that will manufacture industrial Proton-Exchange…

  2. The Integrated Multi-Level Bilingual Teaching of "Social Research Methods"

    Science.gov (United States)

    Zhu, Yanhan; Ye, Jian

    2012-01-01

    "Social Research Methods," as a methodology course, combines theories and practices closely. Based on the synergy theory, this paper tries to establish an integrated multi-level bilingual teaching mode. Starting from the transformation of teaching concepts, we should integrate interactions, experiences, and researches together and focus…

  3. Investigation Clinical Competence and Its Relationship with Professional Ethics and Spiritual Health in Nurses

    Directory of Open Access Journals (Sweden)

    Elahe Ramezanzade Tabriz

    2017-03-01

    Full Text Available Abstract Background and Objectives: Study of clinical competence in nursing helps determine the quality of health care delivered to patients. Given the priority of observance of principles over caretaking and necessity of spirituality existence at the core of health care provision, this study was conducted to investigate clinical competence and its relationship with professional ethics and spiritual health in nurses. Methods: In this cross-sectional, descriptive, and correlational study, 281 nurses were enrolled by consensus sampling. Sampling was conducted from February, 2016 till June, 2016. The data were gathered by a demographics questionnaire, a self-assessment scale of clinical competence, a nursing ethics questionnaire, and a spiritual health questionnaire, and analyzed by descriptive statistics and t-test, Pearson's correlation coefficient, ANOVA, and linear regression analysis in SPSS 21. Results: The total scores for self-assessment scale of nurses' clinical competence, professional ethics, and spiritual health were moderate. In the light of the results of Spearman's correlation coefficient, there was a significant and positive correlation between clinical competence and spiritual health. Moreover, a significant positive correlation was observed between professional ethics and spiritual health but there was no correlation between professional ethics and clinical competence. Conclusion: Managers' and personnel's Knowledge about the level of nurses clinical competence, professional ethics, and spiritual health in teaching health care centers provides valuable information to develop in-service and efficacious education programs and ultimately to improve the quality of nursing services.

  4. Multi-component bi-Hamiltonian Dirac integrable equations

    Energy Technology Data Exchange (ETDEWEB)

    Ma Wenxiu [Department of Mathematics and Statistics, University of South Florida, Tampa, FL 33620-5700 (United States)], E-mail: mawx@math.usf.edu

    2009-01-15

    A specific matrix iso-spectral problem of arbitrary order is introduced and an associated hierarchy of multi-component Dirac integrable equations is constructed within the framework of zero curvature equations. The bi-Hamiltonian structure of the obtained Dirac hierarchy is presented be means of the variational trace identity. Two examples in the cases of lower order are computed.

  5. Curriculum evaluation of ethical reasoning and professional responsibility.

    Science.gov (United States)

    Christie, Carole R; Bowen, Denise M; Paarmann, Carlene S

    2003-01-01

    This exploratory study evaluated curricular content and evaluation mechanisms related to ethics and professionalism in the baccalaureate dental hygiene program at Idaho State University. Competency-based education requires enhanced student preparation in ethical reasoning, critical thinking, and decision-making. Graduates must integrate concepts, beliefs, principles, and values to fulfill ethical and professional responsibilities. Methods included 1) development of five supporting competencies defining ethics and professionalism to provide a framework for curricular evaluation; 2) assessment of all course content and evaluation methods for each supporting competency; 3) evaluation of students' clinical performance based on professional judgment grades; and 4) survey of junior (n=30) and senior (n=27) students' attitudes about dental hygiene practice related to ethics and professionalism. Results revealed that most courses include content and evaluation related to at least one supporting competency; however, authentic evaluation is weak. Clinical instructors rarely relate evaluations to ethical principles or values. Surveys showed significant differences between junior and senior students' attitudes about ethics and professionalism in six of thirty-four areas (the six were laws and regulations; communication and interpersonal skills; problem solving; professional activities/programs; integrity; and safe work environment). This article shares one approach for evaluating curricular content and evaluation methods designed to develop student competence in ethical reasoning and professionalism. Based upon the study's findings, recommendations are made for curricular enhancement via authentic evaluation and faculty training.

  6. Financial and clinical risk in health care reform: a view from below.

    Science.gov (United States)

    Smith, Pam; Mackintosh, Maureen; Ross, Fiona; Clayton, Julie; Price, Linnie; Christian, Sara; Byng, Richard; Allan, Helen

    2012-04-01

    This paper examines how the interaction between financial and clinical risk at two critical phases of health care reform in England has been experienced by frontline staff caring for vulnerable patients with long term conditions. The paper draws on contracting theory and two interdisciplinary and in-depth qualitative research studies undertaken in 1995 and 2007. Methods common to both studies included documentary analysis and interviews with managers and front line professionals. The 1995 study employed action-based research and included observation of community care; the 2007 study used realistic evaluation and included engagement with service user groups. In both reform processes, financial risk was increasingly devolved to frontline practitioners and smaller organizational units such as GP commissioning groups, with payment by unit of activity, aimed at changing professionals' behaviour. This financing increased perceived clinical risk and fragmented the delivery of health and social care services requiring staff efforts to improve collaboration and integration, and created some perverse incentives and staff demoralisation. Health services reform should only shift financial risk to frontline professionals to the extent that it can be efficiently borne. Where team work is required, contracts should reward collaborative multi-professional activity.

  7. Advanced Integrated Multi-Sensor Surveillance (AIMS. Operator Machine Interface (OMI) Definition Study

    National Research Council Canada - National Science Library

    Baker, Kevin; Youngson, Gord

    2007-01-01

    To enhance the capability of airborne search and rescue (SAR) and surveillance, particularly at night and in poor weather, a multi sensor electro optical imaging system, the Advanced Integrated Multi sensor Surveillance (AIMS...

  8. Role of compassion competence among clinical nurses in professional quality of life.

    Science.gov (United States)

    Lee, Y; Seomun, G

    2016-09-01

    The study aimed to explore measurable compassion competence among nurses and to examine the relationships between nurses' compassion competence and levels of compassion satisfaction, compassion fatigue and secondary traumatic stress. Compassion is a vital asset in the nursing profession. It is necessary to explore whether compassion competence is a factor influencing professional quality of life. This study utilized a multicenter descriptive cross-sectional survey. Data were collected from 680 nurses. Professional quality of life based on nurses' general characteristics showed a significant difference in the subjects' age, marital status, education, and total clinical experience. In addition, compassion competence had a significant positive correlation with compassion satisfaction and STS, whereas it had a significant negative correlation with burnout. Compassion competence was a factor influencing compassion satisfaction and burnout in professional quality of life. Our study included nurses with at least 1 year of clinical experience in a single cultural area, which limits its widespread applicability. To improve generalizability, future studies should include clinical nurses of various races, working in diverse cultural areas and with various levels of experience (including entry-level nurses and nursing students). Compassion competence of clinical nurses was a predictive factor for professional quality of life. Hospital administrators, nurse leaders and policy makers should develop and adopt nurse-retaining strategies that focus on improving nurses' compassion competence in order to reduce their burnout. We recommend the development of educational programmes to improve nurses' compassion competence and thereby enhance their professional quality of life. © 2016 International Council of Nurses.

  9. The evolving professional identity of the clinical research nurse: A qualitative exploration.

    Science.gov (United States)

    Kunhunny, Swapna; Salmon, Debra

    2017-12-01

    To examine the perspectives of CRNs in the UK on their professional role identity, in order to inform the professional practice of Clinical Research Nursing. Clinical research nurses (CRN) make a significant contribution to healthcare research within the UK and internationally. However, lack of clarity about their role, and scope of practice renders their contribution within the profession and in the minds of the wider public invisible. This has implications in terms of promoting the role nurses play not only in terms of recruitment, retention, and care of research participants but also as research leaders of the future. Exploratory qualitative design using thematic analysis conducted within a realist paradigm. Participants viewed the positive aspects of their identity 'as agents of change' who were fundamental to the clinical research process. Resourcefulness and the ability to guide members of the research team were valued as key to job satisfaction. Successful navigation through the complexity of advice, support, management and leadership tasks related to their role in caring for research patients were role affirming and generated a sense of pride. However, lack of recognition, clarity of the role and career development opportunities within an identified structure undermined the CRN identity and optimism about progression in the future. Participants reported feeling invisible to colleagues within the clinical community, isolated and excluded from wider nursing groups. The study describes UK CRN practice, highlighting the positive benefits and challenges associated with the role, including the need to support professional and career development to maximise their research contribution. This study provides nurses, health care and research organisations and academic nursing educators with a broadened understanding of the professional role, identity and context of clinical research nursing practice in the United Kingdom, with recommendations to improve its

  10. Impact of a Sustained Job-Embedded Professional Development Program on Classroom Technology Integration

    Science.gov (United States)

    Grashel, Mark A.

    2014-01-01

    The purpose of this single case study was to examine a grant-funded program of professional development (PD) at a small rural high school in Ohio. Evidence has shown that the current model of technology professional development in-service sessions has had little impact on classroom technology integration. This PD program focused on 21st Century…

  11. Inter-Professional Team Objective Structured Clinical Examination (ITOSCE: Teaching and Assessment Strategies of the Inter Professional Approach

    Directory of Open Access Journals (Sweden)

    Fatemeh Keshmiri

    2016-10-01

    Full Text Available Background: In the recent decades, Inter-Professional Team Objective Structured Clinical Examination (ITOSCE has been considered as an efficient tool in evaluating the teamwork and the Inter-professional competences. The aim of this study was to review the literature related ITOSCE as educational tool. Method: This narrative review study was conducted in 2015. Relevant literature was found by searching the databases such as: PubMed, Medline, CINAHL, Google Scholar, Science Direct, EBSCO, ProQuest. Title searching was performed in full English texts without time limitation using keywords including; Team, Inter professional Team, Group, Inter-disciplinary, Objective Structured Clinical Examination (TOSCE, ITOSCE, GOSCE. Results: 19 studies met the inclusion criteria and were included in the analyses. In 13 studies, ITOSCE was used as an assessment tool, and in 6 studies as a learning tool. ITOSCE had been used in several fields such as: obstetrics, gynecology, emergency, palliative care with participating of a variety of disciplines, including: medicine, pharmacy, several trends of nursing, physiotherapy, occupational therapy and Social working. Conclusion: Eventually, it can be noted that ITOSCE plays significant role as an educational and evaluation tool to improve inter-professional teamwork competences among the students. Further studies are needed to develop to examine the psychometric criteria of ITOSCE.

  12. A Systematic Investigation on Barriers and Critical Success Factors for Clinical Information Systems in Integrated Care Settings.

    Science.gov (United States)

    Hoerbst, A; Schweitzer, M

    2015-08-13

    Clinical Information Systems (CIS) have ever since the introduction of information technology in healthcare played an important role to support healthcare professionals and the process of treatment. With the rise of the concept of integrated care organizational borders, the sole focus on data aggregation or healthcare professionals as users disappear more and more. The manuscript discusses the concept of CISs and investigates critical success factors for CISs in the context of integrated care and in the course of time. In order to identify critical success factors and barriers for CISs a systematic literature review was conducted based on the results from PubMed and Cochrane, using MaxQDA. Search results were thereby limited to reviews or meta-analysis. We have found 1919 references of which 40 met the inclusion criteria. The analysis of the manuscripts resulted in a comprehensive list of success factors and barriers related to CISs in integrated care settings. Most barriers were user-related whereas for the success factors an even distribution of organizational, technical and user-related factors was observed. The vast majority of publications was focused on healthcare professionals. It is important to incorporate experiences made/ collected over time, as the problems encountered seem to remain almost unvaried. In order to support further systematic investigations on the topic it is necessary to rethink existing concepts and definitions to realign them with the ideas of integrated care.

  13. Multi-method laboratory user evaluation of an actionable clinical performance information system: Implications for usability and patient safety.

    Science.gov (United States)

    Brown, Benjamin; Balatsoukas, Panos; Williams, Richard; Sperrin, Matthew; Buchan, Iain

    2018-01-01

    Electronic audit and feedback (e-A&F) systems are used worldwide for care quality improvement. They measure health professionals' performance against clinical guidelines, and some systems suggest improvement actions. However, little is known about optimal interface designs for e-A&F, in particular how to present suggested actions for improvement. We developed a novel theory-informed system for primary care (the Performance Improvement plaN GeneratoR; PINGR) that covers the four principal interface components: clinical performance summaries; patient lists; detailed patient-level information; and suggested actions. As far as we are aware, this is the first report of an e-A&F system with all four interface components. (1) Use a combination of quantitative and qualitative methods to evaluate the usability of PINGR with target end-users; (2) refine existing design recommendations for e-A&F systems; (3) determine the implications of these recommendations for patient safety. We recruited seven primary care physicians to perform seven tasks with PINGR, during which we measured on-screen behaviour and eye movements. Participants subsequently completed usability questionnaires, and were interviewed in-depth. Data were integrated to: gain a more complete understanding of usability issues; enhance and explain each other's findings; and triangulate results to increase validity. Participants committed a median of 10 errors (range 8-21) when using PINGR's interface, and completed a median of five out of seven tasks (range 4-7). Errors violated six usability heuristics: clear response options; perceptual grouping and data relationships; representational formats; unambiguous description; visually distinct screens for confusable items; and workflow integration. Eye movement analysis revealed the integration of components largely supported effective user workflow, although the modular design of clinical performance summaries unnecessarily increased cognitive load. Interviews and

  14. Practical Ways of Implementation of the Integrated Approach to Training Professionals in the Field of Professional Communication

    Directory of Open Access Journals (Sweden)

    Olena Zotova-Sadylo

    2018-05-01

    Full Text Available The purpose of the article is to outline the ways of practical implementation of the integrated approach to the training of future specialists, in particular, in the aspect of effective professional communication in native and foreign languages. The analysis of scientific research convincingly proves that the perspective of training specialists, in particular, in the aspect of intercultural business communication, is the direction of integration of the humanitarian knowledge into a professional plane, which gives the opportunity to respond adequately to the challenges of the modern labour market and students’ needs. The article has a practical orientation, therefore theoretical aspects of the research are accompanied by the author’s methodical developments, the content of which is universal and can be used in the process of teaching students of different specialties in both the native and foreign (English languages. Their aim is to help students to acquire sufficient and high levels of theoretical knowledge and practical skills and skills of professional business communication / intercultural business communication. That is what makes it possible to determine the trends of teacher’s pedagogical activity, in particular, the use of modern interactive pedagogical technologies that combine individual and collective forms of work, for example, mixed learning technology, “flip-class”, and personally oriented interaction with students. The newest technologies make students face such tasks, which are not always possible to solve in the lecture-room, sometimes they are designed for consistent co-operation with lecturers of narrow-professional subjects, business organizations and individual non-tutor work. Approbation has confirmed the expediency of the proposed methods in high school and their perspective in the preparation of a competitive specialist.

  15. Integrating Multi-omic features exploiting Chromosome Conformation Capture data

    Directory of Open Access Journals (Sweden)

    Ivan eMerelli

    2015-02-01

    Full Text Available The representation, integration and interpretation of omic data is a complex task, in particular considering the huge amount of information that is daily produced in molecular biology laboratories all around the world. The reason is that sequencing data regarding expression profiles, methylation patterns, and chromatin domains is difficult to harmonize in a systems biology view, since genome browsers only allow coordinate-based representations, discarding functional clusters created by the spatial conformation of the DNA in the nucleus. In this context, recent progresses in high throughput molecular biology techniques and bioinformatics have provided insights into chromatin interactions on a larger scale and offer a formidable support for the interpretation of multi-omic data. In particular, a novel sequencing technique called Chromosome Conformation Capture (3C allows the analysis of the chromosome organization in the cell’s natural state. While performed genome wide, this technique is usually called Hi-C. Inspired by service applications such as Google Maps, we developed NuChart, an R package that integrates Hi-C data to describe the chromosomal neighbourhood starting from the information about gene positions, with the possibility of mapping on the achieved graphs genomic features such as methylation patterns and histone modifications, along with expression profiles. In this paper we show the importance of the NuChart application for the integration of multi-omic data in a systems biology fashion, with particular interest in cytogenetic applications of these techniques. Moreover, we demonstrate how the integration of multi-omic data can provide useful information in understanding why genes are in certain specific positions inside the nucleus and how epigenetic patterns correlate with their expression.

  16. Impact of Professional Development on Level of Technology Integration in the Elementary Classroom

    Science.gov (United States)

    Miktuk, Darlynda

    2012-01-01

    The purpose of the quantitative study was to evaluate the impact of professional development on the level of technology integration within the elementary classroom using an online survey known as the LoTi (levels of teaching innovation) survey. Information about the history of computers, technology integration, andragogy, and effective…

  17. Health Professionals Facing Suicidal Patients: What Are Their Clinical Practices?

    Directory of Open Access Journals (Sweden)

    Inês Rothes

    2018-06-01

    Full Text Available Clinical work with suicidal people is a demanding area. Little is known about health professionals’ practices when faced with suicidal patients. The aims of this study were to: (1 describe the practices most likely to be adopted by professionals facing a suicidal patient and (2 analyze the differences according to professional characteristics (group, specific training on suicide, and experience with suicidal patients. A self-report questionnaire that was developed for this study was filled out by 239 participants. Participants were psychologists, psychiatrists, and general practitioners who work in different contexts: hospitals, public health centres, schools or colleges, and community centres. Principal components analysis, analyses of variance, and t-tests were used. Four components were identified: (1 Comprehensive risk assessment; (2 protocols, psychotherapy and connectedness; (3 multidisciplinary clinical approach; and, (4 family, explaining a total of variance of 44%. Positive associations between suicide-related variables (training and experience and practices were found. In general, health professionals’ practices are evidence-based, however a relevant percentage of professionals can benefit from training and improve their practices.

  18. Multi-channel time-division integrator in HL-2A

    International Nuclear Information System (INIS)

    Yan Ji

    2008-01-01

    HL-2A is China's first Tokamak device with divertor configuration (magnetic confinement controlled nuclear fusion device). To find out the details of on-going fusion reaction at different times is of important significance in achieving controlled nuclear fusion. We developed a new type multi-channel time-division integrator for HL-2A. It has functions of automatic cutting off negative pulse of the input signals, optional integrating time division spacing 0.2-1 ms, TTL starting trigger signal, automatic regularly work 20 s, and integrating 10 channel at the same time. (authors)

  19. Multi-criteria decision analysis integrated with GIS for radio ...

    African Journals Online (AJOL)

    Multi-criteria decision analysis integrated with GIS for radio astronomical observatory site selection in peninsular of Malaysia. R Umar, Z.Z. Abidin, Z.A. Ibrahim, M.K.A. Kamarudin, S.N. Hazmin, A Endut, H Juahir ...

  20. Faculty Professional Development: Advancing Integrative Social Pedagogy Using ePortfolio

    Science.gov (United States)

    Bhika, Rajendra; Francis, Andrea; Miller, Dionne

    2013-01-01

    This article highlights the work of three faculty members across two different professional development seminars at LaGuardia Community College. It illustrates how their work was guided and is linked together by a common thread--the use of ePortfolio to foster integrative social pedagogy--as a result of their participation in these seminars. This…

  1. Creating a professional development platform to transform social work clinical practice in health care.

    Science.gov (United States)

    Xenakis, Nancy

    2018-07-01

    Since U.S. Congress' 2010 passing of the Affordable Care Act and the creation of numerous care coordination programs, Mount Sinai Hospital's Department of Social Work Services has experienced exponential growth. The Department is deeply committed to recruiting and developing the most talented social workers to best meet the needs of patients and family caregivers and to serve as integral, valued members of interdisciplinary care teams. Traditional learning methods are insufficient for a staff of hundreds, given the changes in health care and the complexity of the work. This necessitates the use of new training and education methods to maintain the quality of professional development. This article provides an overview of the Department's strategy and creation of a professional development learning platform to transform clinical social work practice. It reviews various education models that utilize an e-learning management system and case studies using standardized patients. These models demonstrate innovative learning approaches for both new and experienced social workers in health care. The platform's successes and challenges and recommendations for future development and sustainability are outlined.

  2. Multi-objective group scheduling optimization integrated with preventive maintenance

    Science.gov (United States)

    Liao, Wenzhu; Zhang, Xiufang; Jiang, Min

    2017-11-01

    This article proposes a single-machine-based integration model to meet the requirements of production scheduling and preventive maintenance in group production. To describe the production for identical/similar and different jobs, this integrated model considers the learning and forgetting effects. Based on machine degradation, the deterioration effect is also considered. Moreover, perfect maintenance and minimal repair are adopted in this integrated model. The multi-objective of minimizing total completion time and maintenance cost is taken to meet the dual requirements of delivery date and cost. Finally, a genetic algorithm is developed to solve this optimization model, and the computation results demonstrate that this integrated model is effective and reliable.

  3. The death of neonates: the multi-professional team’s perceptions of the problem in the light of its complexity

    Directory of Open Access Journals (Sweden)

    Larissa Spies Subutzki

    2018-01-01

    Full Text Available Objective: to learn about the perception which the multi-professional team of a neonatal intensive care unit have of the process of dying and death of neonates. Method: this is a qualitative, exploratory-descriptive study, undertaken with three focus groups made up of 35 professionals from the multi-professional team of the neonatal and pediatric intensive care unit of a hospital located in the northwest region of the State of Rio Grande do Sul in Brazil. The data were decoded on the basis of content analysis. Results: the data yielded four thematic categories: Death: an interruption of the natural order; Death: dying is a complex process for which there are no answers; Death: awakening to a new state of life and Death: the coexistence of the tangible and the  intangible. Conclusion: is the study concluded that death is still conceived of as a fragmented phenomenon and it is dissociated from the process of human life, although there is evidence that the professionals believe in the prospect of being able to speak about and reflect on the matter and expand their theoretical and practical understanding of death.

  4. Variability in Clinical Integration Achieved by Athletic Training Students across Different Clinical Sport Assignments

    Science.gov (United States)

    Dodge, Thomas M.; Mazerolle, Stephanie M.; Bowman, Thomas G.

    2015-01-01

    Context: Clinical integration impacts athletic training students' (ATSs) motivation and persistence. Research has yet to elucidate the manner in which different clinical placements can influence clinical integration. Objective: To examine differences in the levels of clinical integration achieved by ATSs across various clinical sport assignments.…

  5. Healthcare Practitioners' Personal and Professional Values

    Science.gov (United States)

    Moyo, Mpatisi; Goodyear-Smith, Felicity A.; Weller, Jennifer; Robb, Gillian; Shulruf, Boaz

    2016-01-01

    Personal and professional values of healthcare practitioners influence their clinical decisions. Understanding these values for individuals and across healthcare professions can help improve patient-centred decision-making by individual practitioners and interprofessional teams, respectively. We aimed to identify these values and integrate them…

  6. Attitudes toward suicidal behaviour among professionals at mental health outpatient clinics in Stavropol, Russia and Oslo, Norway

    OpenAIRE

    Norheim, Astrid Berge; Grimholt, Tine K.; Loskutova, Ekaterina; Ekeberg, Oivind

    2016-01-01

    Background Attitudes toward suicidal behaviour can be essential regarding whether patients seek or are offered help. Patients with suicidal behaviour are increasingly treated by mental health outpatient clinics. Our aim was to study attitudes among professionals at outpatient clinics in Stavropol, Russia and Oslo, Norway. Methods Three hundred and forty-eight (82?%) professionals anonymously completed a questionnaire about attitudes. Professionals at outpatient clinics in Stavropol (n?=?119; ...

  7. Challenges from variation across regions in cost effectiveness analysis in multi-regional clinical trials

    Directory of Open Access Journals (Sweden)

    Yunbo Chu

    2016-10-01

    Full Text Available Economic evaluation in the form of cost-effectiveness analysis has become a popular means to inform decisions in healthcare. With multi-regional clinical trials in a global development program becoming a new venue for drug efficacy testing in recent decades, questions in methods for cost-effectiveness analysis in the multi-regional clinical trials setting also emerge. This paper addresses some challenges from variation across regions in cost effectiveness analysis in multi-regional clinical trials. Several discussion points are raised for further attention and a multi-regional clinical trial example is presented to illustrate the implications in industrial application. A general message is delivered to call for a depth discussion by all stakeholders to reach an agreement on a good practice in cost-effectiveness analysis in the multi-regional clinical trials. Meanwhile, we recommend an additional consideration of cost-effectiveness analysis results based on the clinical evidence from a certain homogeneous population as sensitivity or scenario analysis upon data availability.

  8. Challenges and strategies for sustaining youth-friendly health services - a qualitative study from the perspective of professionals at youth clinics in northern Sweden.

    Science.gov (United States)

    Thomée, Suzanne; Malm, Desiré; Christianson, Monica; Hurtig, Anna-Karin; Wiklund, Maria; Waenerlund, Anna-Karin; Goicolea, Isabel

    2016-12-21

    Youth-friendly health-care services - those that are accessible, acceptable, equitable, appropriate and effective for different youth subpopulations - are beneficial for youth health, but not easy to implement and sustain. Sweden is among the few countries where youth-friendly health-care services have been integrated within the public health system and sustained for a long time. This study explores the challenges and strategies in providing sustainable youth-friendly health-care services, from the perspective of professionals working in youth clinics in northern Sweden. Eleven semi-structured interviews with various health-care professionals working in youth clinics in northern Sweden were conducted. The interviews were transcribed verbatim, and analysed using thematic analysis in relation to the World Health Organization domains of youth friendliness. Four themes emerged from the analysis of the data: 1) 'Meeting youths on their own terms - the key to ensuring a holistic and youth-centred care' was related to the acceptability and appropriateness of the services; 2) 'Organizational challenges and strategies in keeping professionals' expertise on youth updated' referred to the domain of effectiveness; 3) 'Youth clinics are accessible for those who know and can reach them' was related to the domains of accessibility and equity, and 4) 'The challenge of combining strong directions and flexibility in diverse local realities' focused on the struggle to sustain the youth clinics organization and their goals within the broader health system. Professionals working in youth clinics are perceived as motivated, interested and knowledgeable about youth, and the clinics ensure confidentiality and a youth-centred and holistic approach. Challenges remain, especially in terms of ensuring equitable access to different youth subpopulations, improving monitoring routines and ensuring training and competence for all professionals, independently of the location and characteristics of

  9. Professional ASPNET Design Patterns

    CERN Document Server

    Millett, Scott

    2010-01-01

    Professional ASP.NET Design Patterns will show you how to implement design patterns in real ASP.NET applications by introducing you to the basic OOP skills needed to understand and interpret design patterns. A sample application used throughout the book is an enterprise level ASP.NET website with multi-tiered, SOA design techniques that can be applied to your future ASP.NET projects. Read about each design pattern in detail, including how to interpret the UML design, how to implement it in ASP.NET, its importance for ASP.NET development, and how it's integrated into the final project.

  10. Method to integrate clinical guidelines into the electronic health record (EHR) by applying the archetypes approach.

    Science.gov (United States)

    Garcia, Diego; Moro, Claudia Maria Cabral; Cicogna, Paulo Eduardo; Carvalho, Deborah Ribeiro

    2013-01-01

    Clinical guidelines are documents that assist healthcare professionals, facilitating and standardizing diagnosis, management, and treatment in specific areas. Computerized guidelines as decision support systems (DSS) attempt to increase the performance of tasks and facilitate the use of guidelines. Most DSS are not integrated into the electronic health record (EHR), ordering some degree of rework especially related to data collection. This study's objective was to present a method for integrating clinical guidelines into the EHR. The study developed first a way to identify data and rules contained in the guidelines, and then incorporate rules into an archetype-based EHR. The proposed method tested was anemia treatment in the Chronic Kidney Disease Guideline. The phases of the method are: data and rules identification; archetypes elaboration; rules definition and inclusion in inference engine; and DSS-EHR integration and validation. The main feature of the proposed method is that it is generic and can be applied toany type of guideline.

  11. Distributed and multi-core computation of 2-loop integrals

    International Nuclear Information System (INIS)

    De Doncker, E; Yuasa, F

    2014-01-01

    For an automatic computation of Feynman loop integrals in the physical region we rely on an extrapolation technique where the integrals of the sequence are obtained with iterated/repeated adaptive methods from the QUADPACK 1D quadrature package. The integration rule evaluations in the outer level, corresponding to independent inner integral approximations, are assigned to threads dynamically via the OpenMP runtime in the parallel implementation. Furthermore, multi-level (nested) parallelism enables an efficient utilization of hyperthreading or larger numbers of cores. For a class of loop integrals in the unphysical region, which do not suffer from singularities in the interior of the integration domain, we find that the distributed adaptive integration methods in the multivariate PARINT package are highly efficient and accurate. We apply these techniques without resorting to integral transformations and report on the capabilities of the algorithms and the parallel performance for a test set including various types of two-loop integrals

  12. Systematic approximation of multi-scale Feynman integrals arXiv

    CERN Document Server

    Borowka, Sophia; Hulme, Daniel

    An algorithm for the systematic analytical approximation of multi-scale Feynman integrals is presented. The algorithm produces algebraic expressions as functions of the kinematical parameters and mass scales appearing in the Feynman integrals, allowing for fast numerical evaluation. The results are valid in all kinematical regions, both above and below thresholds, up to in principle arbitrary orders in the dimensional regulator. The scope of the algorithm is demonstrated by presenting results for selected two-loop three-point and four-point integrals with an internal mass scale that appear in the two-loop amplitudes for Higgs+jet production.

  13. Authorship issues in multi-centre clinical trials

    DEFF Research Database (Denmark)

    Rosenberg, Jacob; Burcharth, Jakob; Pommergaard, Hans-Christian

    2015-01-01

    Discussions about authorship often arise in multi-centre clinical trials. Such trials may involve up to hundreds of contributors of whom some will eventually co-author the final publication. It is, however, often impossible to involve all contributors in the manuscript process sufficiently for th...

  14. The use of clinical practice guidelines in primary care: professional mindlines and control mechanisms.

    Science.gov (United States)

    Gené-Badia, Joan; Gallo, Pedro; Caïs, Jordi; Sánchez, Emília; Carrion, Carme; Arroyo, Liliana; Aymerich, Marta

    2016-01-01

    To identify the relevant barriers and enablers perceived by primary care professionals in implementing the recommendations of clinical practice guidelines (CPG). Two focus groups were conducted with primary care physicians and nurses in Catalonia (Spain) between October and December 2012. Thirty-nine health professionals were selected based on their knowledge and daily use of CPG. Finally, eight general practitioners and eight nurses were included in the discussion groups. Participants were asked to share their views and beliefs on the accessibility of CPG, their knowledge and use of these documents, the content and format of CPG, dissemination strategy, training, professional-patient relationship, and the use of CPG by the management structure. We recorded and transcribed the content verbatim and analysed the data using qualitative analysis techniques. Physicians believed that, overall, CPG were of little practical use and frequently referred to them as a largely bureaucratic management control instrument that threatened their professional autonomy. In contrast, nurses believed that CPG were rather helpful tools in their day-to-day practice, although they would like them to be more sensitive to the current role of nurses. Both groups believed that CPG did not provide a response to most of the decisions they faced in the primary care setting. Compliance with CPG recommendations would be improved if these documents were brief, non-compulsory, not cost-containment oriented, more based on nursing care models, sensitive to the specific needs of primary care patients, and integrated into the computer workstation. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Professional training in physiotherapy: barriers to the diversification of practical learning scenarios and for teaching-service integration

    Directory of Open Access Journals (Sweden)

    Ana Paula Maihack Gauer

    2018-06-01

    Full Text Available Abstract Introduction: Professional training in health, at present, aims to develop competencies and skills for a performance according the principles of the Unified Health System (SUS, in Portuguese. In this sense, the Ministries of Health and Education have set up devices for training reorientation that prioritize teaching-service integration and diversification of learning scenarios. Objective: To describe barriers to the diversification of practical learning scenarios and for teaching-service integration in a physiotherapy course from the perspective of teachers and students. Methods: This is a qualitative research developed according to the case study method, with the participation of 16 students and 11 teachers-physiotherapists. During the data collection three focus groups were established, two with students and one with professors, besides individual interviews with both the course coordinator and the pedagogical articulator of the National Program for the Reorientation of Professional Health Training of the assessed course. Data were analyzed through thematic content analysis. Results: Among the identified barriers there are students’ low participation in public health services; saturation of public health services for students to carry out practical activities; low number of physiotherapists in Primary Care; indirect relationship of Clinical School with SUS. Conclusion: In order to improve the teaching-service interaction and to diversify the learning scenarios it is necessary to prioritize an integrated planning of actions to overcome identified barriers, including the participation of both the university managers and health services.

  16. Multi-walled carbon nanotubes integrated in microcantilevers for application of tensile strain

    DEFF Research Database (Denmark)

    Dohn, Søren; Kjelstrup-Hansen, Jakob; Madsen, D.N.

    2005-01-01

    variations in the response. Using a simple resistor model we estimate the expected conductance-strain response for a multi-walled carbon nanotube, and compare to our results on multi-walled carbon nanotubes as well as measurements by others on single-walled carbon nanotubes. Integration of nanotubes...

  17. Deciding Access to Work-Integrated Learning: Human Resource Professionals as Gatekeepers

    Science.gov (United States)

    Mackaway, Jacqueline; Winchester-Seeto, Theresa

    2018-01-01

    Universities, industry and professional bodies advocate work-integrated learning (WIL) as a valuable way to prepare graduates to meet the challenges of contemporary society. When organizations preference particular students over others to host on placement, the full individual and collective potential of WIL is not realized. This paper reports…

  18. [Equality in clinical practice. Proposals for patients, professionals and managers and policies to limit discrimination].

    Science.gov (United States)

    Soler-González, J; Fernández de Sanmamed, M J; Gérvas, J

    2015-01-01

    To make feasible and practical proposals to improve equality in the course of clinical care during the patient-provider encounter. Design: A focus group study was conducted with a qualitative approach from the perspective of reducing health inequalities in the clinic. Setting: A classroom discussion focused on equality in clinical work. Subjects: 98 professionals from several countries. Measurement tools: An analysis of the responses was performed, grouped by themes interpreted by analysts, and restructured to provide consistency and uniformity to responses given. Data were collected using a questionnaire with open answers, allowing free-form answers to three general questions that addressed improving equality from the perspective of the professional themselves, patients, and health policy managers. No saturation horizon of analytical discourses was set, to understand that from this subjective prioritization of opinion there is no possibility that discourses reached saturation. Responses were added to the 3 principal axes, recommending that professionals be aware of their discriminatory ability. Patients were asked to trust their health professionals and that they should be assigned to a professional. It was also proposed that managers provide information systems, help reduce health inequalities, and encourage professional freedom. The paper presents concrete measures to promote improved equality in clinics during the delivery of health care. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  19. Open pre-schools at integrated health services - A program theory

    Directory of Open Access Journals (Sweden)

    Agneta Abrahamsson

    2013-04-01

    Full Text Available Introduction: Family centres in Sweden are integrated services that reach all prospective parents and parents with children up to their sixth year, because of the co-location of the health service with the social service and the open pre-school. The personnel on the multi-professional site work together to meet the needs of the target group. The article explores a program theory focused on the open pre-schools at family centres.Method: A multi-case design is used and the sample consists of open pre-schools at six family centres. The hypothesis is based on previous research and evaluation data. It guides the data collection which is collected and analysed stepwise. Both parents and personnel are interviewed individually and in groups at each centre.Findings: The hypothesis was expanded to a program theory. The compliance of the professionals was the most significant element that explained why the open access service facilitated positive parenting. The professionals act in a compliant manner to meet the needs of the children and parents as well as in creating good conditions for social networking and learning amongst the parents. Conclusion: The compliance of the professionals in this program theory of open pre-schools at family centres can be a standard in integrated and open access services, whereas the organisation form can vary. The best way of increasing the number of integrative services is to support and encourage professionals that prefer to work in a compliant manner.

  20. Open pre-schools at integrated health services - A program theory

    Directory of Open Access Journals (Sweden)

    Agneta Abrahamsson

    2013-04-01

    Full Text Available Introduction: Family centres in Sweden are integrated services that reach all prospective parents and parents with children up to their sixth year, because of the co-location of the health service with the social service and the open pre-school. The personnel on the multi-professional site work together to meet the needs of the target group. The article explores a program theory focused on the open pre-schools at family centres. Method: A multi-case design is used and the sample consists of open pre-schools at six family centres. The hypothesis is based on previous research and evaluation data. It guides the data collection which is collected and analysed stepwise. Both parents and personnel are interviewed individually and in groups at each centre. Findings: The hypothesis was expanded to a program theory. The compliance of the professionals was the most significant element that explained why the open access service facilitated positive parenting. The professionals act in a compliant manner to meet the needs of the children and parents as well as in creating good conditions for social networking and learning amongst the parents. Conclusion: The compliance of the professionals in this program theory of open pre-schools at family centres can be a standard in integrated and open access services, whereas the organisation form can vary. The best way of increasing the number of integrative services is to support and encourage professionals that prefer to work in a compliant manner.

  1. Cooperation of return-to-work professionals: the challenges of multi-actor work disability management.

    Science.gov (United States)

    Liukko, Jyri; Kuuva, Niina

    2017-07-01

    This article explores which concrete factors hinder or facilitate the cooperation of return-to-work (RTW) professionals in a complex system of multiple stakeholders. The empirical material consists of in-depth interviews with 24 RTW professionals from various organizations involved in work disability management in Finland. The interviews were analyzed using thematic content analysis. The study revealed several kinds of challenges in the cooperation of the professionals. These were related to two partly interrelated themes: communication and distribution of responsibility. The most difficult problems were connected to the cooperation between public employment offices and other stakeholders. However, the study distinguished notable regional differences depending primarily on the scale of the local network. The main areas of improvement proposed by the interviewees were related to better networking of case managers and expansion of expertise. The article argues for the importance of systematic networking and stresses the role of public employment services in the multi-actor management of work disabilities. The article contributes to existing work disability case management models by suggesting the employment administration system as an important component in addition to health care, workplace and insurance systems. The study also highlights the need for expansion of expertise in the field. Implications for Rehabilitation Cooperation between RTW professionals in public employment offices and other organizations involved in work disability management was considered inadequate. In order to improve the cooperation of RTW professionals, the stakeholders need to create more systematic ways of communication and networking with professionals in other organizations. There is a need to expand the expertise in work disability management and rehabilitation, partly by increasing the role of other professionals than physicians.

  2. Nursing students´perception of taking part in an Inter-professional Clinical Study Unit

    DEFF Research Database (Denmark)

    Bahnsen, Iben Bøgh; Braad, Mette; Lisby, Hanne

    2013-01-01

    the stay at ICSU in their final clinical placement. Moreover, students spent a considerable amount of time an basic nursing tasks during their stay at the ICSU; skills already acquired earlier in their education programme. Conclusion: Staying in an ICSU improved inter-professional collaboration skills......Background: Length of hospitalization is reduced demanding effective and timely interventions from all health professions. In an Inter-professional Clinical Study Unit (ICSU) students have the opportunity to develop inter-professional competencies. Nevertheless some nursing students have commented...... that staying in an ICSU is an interruption in their final clinical placement with limited learning possibilities. Aim: The aim of the study was to explore nursing students´perceptions of taking part in an ICSU Methods: The study was qualitative with explorative, decriptive and interpretative aspects. Data were...

  3. A transition from using multi-step procedures to a fully integrated system for performing extracorporeal photopheresis: A comparison of costs and efficiencies.

    Science.gov (United States)

    Azar, Nabih; Leblond, Veronique; Ouzegdouh, Maya; Button, Paul

    2017-12-01

    The Pitié Salpêtrière Hospital Hemobiotherapy Department, Paris, France, has been providing extracorporeal photopheresis (ECP) since November 2011, and started using the Therakos ® CELLEX ® fully integrated system in 2012. This report summarizes our single-center experience of transitioning from the use of multi-step ECP procedures to the fully integrated ECP system, considering the capacity and cost implications. The total number of ECP procedures performed 2011-2015 was derived from department records. The time taken to complete a single ECP treatment using a multi-step technique and the fully integrated system at our department was assessed. Resource costs (2014€) were obtained for materials and calculated for personnel time required. Time-driven activity-based costing methods were applied to provide a cost comparison. The number of ECP treatments per year increased from 225 (2012) to 727 (2015). The single multi-step procedure took 270 min compared to 120 min for the fully integrated system. The total calculated per-session cost of performing ECP using the multi-step procedure was greater than with the CELLEX ® system (€1,429.37 and €1,264.70 per treatment, respectively). For hospitals considering a transition from multi-step procedures to fully integrated methods for ECP where cost may be a barrier, time-driven activity-based costing should be utilized to gain a more comprehensive understanding the full benefit that such a transition offers. The example from our department confirmed that there were not just cost and time savings, but that the time efficiencies gained with CELLEX ® allow for more patient treatments per year. © 2017 The Authors Journal of Clinical Apheresis Published by Wiley Periodicals, Inc.

  4. Integration of multi-level marketing management systems geographically industry development

    OpenAIRE

    Aleksandr Lavrov; Lada Polikarpova; Alla Handramai

    2015-01-01

    In the article the authors attempt to develop a multi-level management system territorially industry development in market conditions, built in the widespread use of various types of marketing and their horizontal and vertical integration.

  5. Multi-fields' coordination information integrated platform for nuclear power plant operation preparation

    International Nuclear Information System (INIS)

    Yuan Chang; Li Yong; Ye Zhiqiang

    2011-01-01

    To realize the coordination in multi-fields' work and information sharing, by applying the method of Enterprise Architecture (EA), the business architecture, functional flow and application architecture of Nuclear Power Plant's operation preparation information integrated platform are designed, which can realize the information sharing and coordination of multi fields. (authors)

  6. High Entrepreneurship, Leadership, and Professionalism (HELP): Toward an Integrated, Empirically Based Perspective.

    Science.gov (United States)

    Di Fabio, Annamaria; Bucci, Ornella; Gori, Alessio

    2016-01-01

    This article evaluates the psychometric properties of a new measure for assessing the constructs of entrepreneurship, leadership, and professionalism, from an integrated point of view, the High Entrepreneurship, Leadership and Professionalism Questionnaire (HELP-Q). Exploratory factor analysis indicated a factor structure with three principal dimensions, and confirmatory factor analysis and goodness of fit indices indicated a good fit of the model to the data. All the dimensions showed good values of internal consistency. The results of the study thus indicate that the HELP-Q is a short and easily administered instrument with good psychometric properties that can promote entrepreneurship, leadership, and professionalism in workers as well as in those who are preparing to enter the turbulent 21st century labor market.

  7. High Entrepreneurship, Leadership, and Professionalism (HELP): Toward an Integrated, Empirically Based Perspective

    Science.gov (United States)

    Di Fabio, Annamaria; Bucci, Ornella; Gori, Alessio

    2016-01-01

    This article evaluates the psychometric properties of a new measure for assessing the constructs of entrepreneurship, leadership, and professionalism, from an integrated point of view, the High Entrepreneurship, Leadership and Professionalism Questionnaire (HELP-Q). Exploratory factor analysis indicated a factor structure with three principal dimensions, and confirmatory factor analysis and goodness of fit indices indicated a good fit of the model to the data. All the dimensions showed good values of internal consistency. The results of the study thus indicate that the HELP-Q is a short and easily administered instrument with good psychometric properties that can promote entrepreneurship, leadership, and professionalism in workers as well as in those who are preparing to enter the turbulent 21st century labor market. PMID:27933015

  8. High Entrepreneurship, Leadership, and Professionalism (HELP: towards an integrated, empirically based perspective

    Directory of Open Access Journals (Sweden)

    Annamaria Di Fabio

    2016-11-01

    Full Text Available This article evaluates the psychometric properties of a new measure for assessing the constructs of entrepreneurship, leadership, and professionalism, from an integrated point of view, the High Entrepreneurship, Leadership and Professionalism Questionnaire (HELP-Q. Exploratory factor analysis indicated a factor structure with three principal dimensions, and confirmatory factor analysis and goodness of fit indices indicated a good fit of the model to the data. All the dimensions showed good values of internal consistency. The results of the study thus indicate that the HELP-Q is a short and easily administered instrument with good psychometric properties that can promote entrepreneurship, leadership, and professionalism in workers as well as in those who are preparing to enter the turbulent 21st century labor market.

  9. Integrated Lens Antennas for Multi-Pixel Receivers

    Science.gov (United States)

    Lee, Choonsup; Chattopadhyay, Goutam

    2011-01-01

    Future astrophysics and planetary experiments are expected to require large focal plane arrays with thousands of detectors. Feedhorns have excellent performance, but their mass, size, fabrication challenges, and expense become prohibitive for very large focal plane arrays. Most planar antenna designs produce broad beam patterns, and therefore require additional elements for efficient coupling to the telescope optics, such as substrate lenses or micromachined horns. An antenna array with integrated silicon microlenses that can be fabricated photolithographically effectively addresses these issues. This approach eliminates manual assembly of arrays of lenses and reduces assembly errors and tolerances. Moreover, an antenna array without metallic horns will reduce mass of any planetary instrument significantly. The design has a monolithic array of lens-coupled, leaky-wave antennas operating in the millimeter- and submillimeter-wave frequencies. Electromagnetic simulations show that the electromagnetic fields in such lens-coupled antennas are mostly confined in approximately 12 15 . This means that one needs to design a small-angle sector lens that is much easier to fabricate using standard lithographic techniques, instead of a full hyper-hemispherical lens. Moreover, this small-angle sector lens can be easily integrated with the antennas in an array for multi-pixel imager and receiver implementation. The leaky antenna is designed using double-slot irises and fed with TE10 waveguide mode. The lens implementation starts with a silicon substrate. Photoresist with appropriate thickness (optimized for the lens size) is spun on the substrate and then reflowed to get the desired lens structure. An antenna array integrated with individual lenses for higher directivity and excellent beam profile will go a long way in realizing multi-pixel arrays and imagers. This technology will enable a new generation of compact, low-mass, and highly efficient antenna arrays for use in multi

  10. Clinical Engineering: Experiences of assisted professional practices

    International Nuclear Information System (INIS)

    Langone, Luis; Vanetta, Marcos; Vazquez, Marcelo; Rotger, Viviana I; Olivera, Juan Manuel

    2007-01-01

    In the curricula of the Biomedical Engineering career of the Facultad de Ciencias Exactas y TecnologIa of the Universidad Nacional de Tucuman, Argenitna, there are the Assisted Professional Practices. Within this framework, the students have the possibility of performing practices in the clinic Sanatorio 9 de Julio. One of the objectives of these practices is to apply the concepts, methods and procedures studied along the career in the field work under real work conditions. From the point of view of the host institution, the objective is to improve the performance of the different services and areas applying the tools of Biomedical Engineering. The present work shows an example of such practices where an equipment preliminary analysis was made, its use and maintenance corresponding to the surgical unit of the clinic

  11. Collective Professional Development for the Integration of ICT in Higher Education

    DEFF Research Database (Denmark)

    Castro Guzman, Willy

    In this thesis, I explore, analyse and reflect on the individual practice of adoption and the collective practice of integration of technology in teaching and learning in a Higher Education Institution. The study addresses the connections between ICT adoption in Education, the barriers of ICT...... integration, and the teacher professional development as means to promote adoption. With the recognition of the potential of ICT in education, the study reflects the appropriateness of the dominant traditional approach to the first and second-order barriers to technology and attempts to overcome...

  12. Your professionalism is not my professionalism: congruence and variance in the views of medical students and faculty about professionalism.

    Science.gov (United States)

    Sattar, Kamran; Roff, Sue; Meo, Sultan Ayoub

    2016-11-08

    Medical professionalism is an essential aspect of medical education and practice worldwide and it must be adopted according to different social and cultural contexts. We examined the current congruence and variance in the perception of professionalism in undergraduate medical students and faculty members in one medical school in Saudi Arabia. The target population was first year to final year medical students of College of Medicine, King Saud University. Out of a total of 1431 students at College of Medicine 750 students (52 %) participated in the study. Fifty faculty members from clinical and non-clinical departments of the College of Medicine were randomly selected for this study and all participated in the study. The respondents recorded their responses through the Bristol online survey system, using a bilingual (English and Arabic) version of the Dundee Polyprofessionalism Inventory I: Academic integrity, which has 34 items. There are 17 lapses (50 % of the total) in professional behaviour where none of the faculty recommend the ignore sanction while students recommended a variable ignore sanction in a range of 6-29 % for different behaviours. Students and faculty recommended similar sanctions for 5 lapses (14.7 % of the total) in professional behaviours. Furthermore, there is statistically significant two level difference between the sanctions approved by faculty and students in the recommended sanctions for 12 lapses (35 % of the total (p < 0.050). These results raised concerns in relation to the students' understanding of professionalism. It is therefore, important to enhance their learning around the attributes of medical professionalism.

  13. Experienced job autonomy among maternity care professionals in The Netherlands.

    Science.gov (United States)

    Perdok, Hilde; Cronie, Doug; van der Speld, Cecile; van Dillen, Jeroen; de Jonge, Ank; Rijnders, Marlies; de Graaf, Irene; Schellevis, François G; Verhoeven, Corine J

    2017-11-01

    High levels of experienced job autonomy are found to be beneficial for healthcare professionals and for the relationship with their patients. The aim of this study was to assess how maternity care professionals in the Netherlands perceive their job autonomy in the Dutch maternity care system and whether they expect a new system of integrated maternity care to affect their experienced job autonomy. A cross-sectional survey. The Leiden Quality of Work Life Questionnaire was used to assess experienced job autonomy among maternity care professionals. Data were collected in the Netherlands in 2015. 799 professionals participated of whom 362 were primary care midwives, 240 obstetricians, 93 clinical midwives and 104 obstetric nurses. The mean score for experienced job autonomy was highest for primary care midwives, followed by obstetricians, clinical midwives and obstetric nurses. Primary care midwives scored highest in expecting to lose their job autonomy in an integrated care system. There are significant differences in experienced job autonomy between maternity care professionals. When changing the maternity care system it will be a challenge to maintain a high level of experienced job autonomy for professionals. A decrease in job autonomy could lead to a reduction in job related wellbeing and in satisfaction with care among pregnant women. Copyright © 2017. Published by Elsevier Ltd.

  14. Integrated product development and experience of communication in education

    NARCIS (Netherlands)

    H. Ihle; Ir. Dick van Schenk Brill; Ir. Peter van Kollenburg; Ir. H.E.V. Veenstra

    2000-01-01

    The Technical Departments at the Fontys University of Professional Education in Eindhoven, The Netherlands, offer a course which is devel-oped around the principles of Concurrent Engi-neering. Integrated Product Development (IPD) project teams are multi-disciplinary groups which develop products in

  15. The Role of Technical Advances in the Adoption and Integration of Patient-Reported Outcomes in Clinical Care

    Science.gov (United States)

    Jensen, Roxanne E.; Rothrock, Nan E.; DeWitt, Esi Morgan; Spiegel, Brennan; Tucker, Carole A.; Crane, Heidi M.; Forrest, Christopher B.; Patrick, Donald L.; Fredericksen, Rob; Shulman, Lisa M.; Cella, David; Crane, Paul K.

    2016-01-01

    Background Patient-reported outcomes (PROs) are gaining recognition as key measures for improving the quality of patient care in clinical care settings. Three factors have made the implementation of PROs in clinical care more feasible: increased use of modern measurement methods in PRO design and validation, rapid progression of technology (e.g., touch screen tablets, Internet accessibility, and electronic health records (EHRs)), and greater demand for measurement and monitoring of PROs by regulators, payers, accreditors, and professional organizations. As electronic PRO collection and reporting capabilities have improved, the challenges of collecting PRO data have changed. Objectives To update information on PRO adoption considerations in clinical care, highlighting electronic and technical advances with respect to measure selection, clinical workflow, data infrastructure, and outcomes reporting. Methods Five practical case studies across diverse healthcare settings and patient populations are used to explore how implementation barriers were addressed to promote the successful integration of PRO collection into the clinical workflow. The case studies address selecting and reporting of relevant content, workflow integration, pre-visit screening, effective evaluation, and EHR integration. Conclusions These case studies exemplify elements of well-designed electronic systems, including response automation, tailoring of item selection and reporting algorithms, flexibility of collection location, and integration with patient health care data elements. They also highlight emerging logistical barriers in this area, such as the need for specialized technological and methodological expertise, and design limitations of current electronic data capture systems. PMID:25588135

  16. Evaluation of learning from Practical Obstetric Multi-Professional Training and its impact on patient outcomes in Australia using Kirkpatrick's framework: a mixed methods study.

    Science.gov (United States)

    Kumar, Arunaz; Sturrock, Sam; Wallace, Euan M; Nestel, Debra; Lucey, Donna; Stoyles, Sally; Morgan, Jenny; Neil, Peter; Schlipalius, Michelle; Dekoninck, Philip

    2018-02-17

    The aim of this study was to evaluate the implementation of the Practical Obstetric Multi-Professional Training (PROMPT) simulation using the Kirkpatrick's framework. We explored participants' acquisition of knowledge and skills, its impact on clinical outcomes and organisational change to integrate the PROMPT programme as a credentialing tool. We also aimed to assess participants' perception of usefulness of PROMPT in their clinical practice. Mixed methods approach with a pre-test/post-test design. Healthcare network providing obstetric care in Victoria, Australia. Medical and midwifery staff attending PROMPT between 2013 and 2015 (n=508); clinical outcomes were evaluated in two cohorts: 2011-2012 (n=15 361 births) and 2014-2015 (n=12 388 births). Attendance of the PROMPT programme, a simulation programme taught in multidisciplinary teams to facilitate teaching emergency obstetric skills. Clinical outcomes compared before and after embedding PROMPT in educational practice. Assessment of knowledge gained by participants through a qualitative analysis and description of process of embedding PROMPT in educational practice. There was a change in the management of postpartum haemorrhage by early recognition and intervention. The key learning themes described by participants were being prepared with a prior understanding of procedures and equipment, communication, leadership and learning in a safe, supportive environment. Participants reported a positive learning experience and increase in confidence in managing emergency obstetric situations through the PROMPT programme, which was perceived as a realistic demonstration of the emergencies. Participants reported an improvement of both clinical and non-technical skills highlighting principles of teamwork, communication, leadership and prioritisation in an emergency situation. An improvement was observed in management of postpartum haemorrhage, but no significant change was noted in clinical outcomes over a 2-year period

  17. Integration of XNAT/PACS, DICOM, and research software for automated multi-modal image analysis

    Science.gov (United States)

    Gao, Yurui; Burns, Scott S.; Lauzon, Carolyn B.; Fong, Andrew E.; James, Terry A.; Lubar, Joel F.; Thatcher, Robert W.; Twillie, David A.; Wirt, Michael D.; Zola, Marc A.; Logan, Bret W.; Anderson, Adam W.; Landman, Bennett A.

    2013-03-01

    Traumatic brain injury (TBI) is an increasingly important public health concern. While there are several promising avenues of intervention, clinical assessments are relatively coarse and comparative quantitative analysis is an emerging field. Imaging data provide potentially useful information for evaluating TBI across functional, structural, and microstructural phenotypes. Integration and management of disparate data types are major obstacles. In a multi-institution collaboration, we are collecting electroencephalogy (EEG), structural MRI, diffusion tensor MRI (DTI), and single photon emission computed tomography (SPECT) from a large cohort of US Army service members exposed to mild or moderate TBI who are undergoing experimental treatment. We have constructed a robust informatics backbone for this project centered on the DICOM standard and eXtensible Neuroimaging Archive Toolkit (XNAT) server. Herein, we discuss (1) optimization of data transmission, validation and storage, (2) quality assurance and workflow management, and (3) integration of high performance computing with research software.

  18. Labor market integration, immigration experience, and psychological distress in a multi-ethnic sample of immigrants residing in Portugal.

    Science.gov (United States)

    Teixeira, Ana F; Dias, Sónia F

    2018-01-01

    This study aims at examining how factors relating to immigrants' experience in the host country affect psychological distress (PD). Specifically, we analyzed the association among socio-economic status (SES), integration in the labor market, specific immigration experience characteristics, and PD in a multi-ethnic sample of immigrant individuals residing in Lisbon, Portugal. Using a sample (n = 1375) consisting of all main immigrant groups residing in Portugal's metropolitan area of Lisbon, we estimated multivariable linear regression models of PD regressed on selected sets of socio-economic independent variables. A psychological distress scale was constructed based on five items (feeling physically tired, feeling psychologically tired, feeling happy, feeling full of energy, and feeling lonely). Variables associated with a decrease in PD are being a male (demographic), being satisfied with their income level (SES), living with the core family and having higher number of children (social isolation), planning to remain for longer periods of time in Portugal (migration project), and whether respondents considered themselves to be in good health condition (subjective health status). Study variables negatively associated with immigrants' PD were job insecurity (labor market), and the perception that health professionals were not willing to understand immigrants during a clinical interaction. The study findings emphasized the importance of labor market integration and access to good quality jobs for immigrants' psychological well-being, as well as the existence of family ties in the host country, intention to reside long term in the host country, and high subjective (physical) health. Our research suggests the need to foster cross-national studies of immigrant populations in order to understand the social mechanisms that transverse all migrant groups and contribute to lower psychological well-being.

  19. Professional Development for International Teachers: Examining TPACK and Technology Integration Decision Making

    Science.gov (United States)

    Dalal, Medha; Archambault, Leanna; Shelton, Catharyn

    2017-01-01

    This mixed-methods study explored the impacts of a semester-long technology professional development for secondary school international teachers from developing nations around the world. We used (a) a survey approach to examine international teachers' perceived technology integration abilities using the technological pedagogical content knowledge…

  20. Cost-effectiveness of an integrated 'fast track' rehabilitation service for multi-trauma patients involving dedicated early rehabilitation intervention programs: design of a prospective, multi-centre, non-randomised clinical trial.

    NARCIS (Netherlands)

    Kosar, S.; Seelen, H.A.M.; Hemmen, B.; Evers, S.M.; Brink, P.R.

    2009-01-01

    ABSTRACT: BACKGROUND: In conventional multi-trauma care service (CTCS), patients are admitted to hospital via the accident & emergency room. After surgery they are transferred to the IC-unit followed by the general surgery ward. Ensuing treatment takes place in a hospital's outpatient clinic, a

  1. Hierarchies of multi-component mKP equations and theirs integrable couplings

    International Nuclear Information System (INIS)

    Ji Jie; Yao Yuqin; Zhu Fubo; Chen Dengyuan

    2008-01-01

    First, a new multi-component modified Kadomtsev-Petviashvill (mKP) spectral problem is constructed by k-constraint imposed on a general pseudo-differential operator. Then, two hierarchies of multi-component mKP equations are derived, including positive non-isospectral mKP hierarchy and negative non-isospectral mKP hierarchy. Moreover, new integrable couplings of the resulting mKP soliton hierarchies are constructed by enlarging the associated matrix spectral problem

  2. Explicit solutions of the multi-loop integral recurrence relations and its application

    International Nuclear Information System (INIS)

    Baikov, P.A.

    1997-01-01

    Approaches to construct explicit solutions of the recurrence relations for multi-loop integrals are suggested. The resulting formulas demonstrate a high efficiency, at least for the 3-loop vacuum integral case. They also produce a new type of recurrence relations over the space-time dimension. (orig.)

  3. Intensity correction method customized for multi-animal abdominal MR imaging with 3 T clinical scanner and multi-array coil

    International Nuclear Information System (INIS)

    Mitsuda, Minoru; Yamaguchi, Masayuki; Nakagami, Ryutaro; Furuta, Toshihiro; Fujii, Hirofumi; Sekine, Norio; Niitsu, Mamoru; Moriyama, Noriyuki

    2013-01-01

    Simultaneous magnetic resonance (MR) imaging of multiple small animals in a single session increases throughput of preclinical imaging experiments. Such imaging using a 3-tesla clinical scanner with multi-array coil requires correction of intensity variation caused by the inhomogeneous sensitivity profile of the coil. We explored a method for correcting intensity that we customized for multi-animal MR imaging, especially abdominal imaging. Our institutional committee for animal experimentation approved the protocol. We acquired high resolution T 1 -, T 2 -, and T 2 * -weighted images and low resolution proton density-weighted images (PDWIs) of 4 rat abdomens simultaneously using a 3T clinical scanner and custom-made multi-array coil. For comparison, we also acquired T 1 -, T 2 -, and T 2 * -weighted volume coil images in the same rats in 4 separate sessions. We used software created in-house to correct intensity variation. We applied thresholding to the PDWIs to produce binary images that displayed only a signal-producing area, calculated multi-array coil sensitivity maps by dividing low-pass filtered PDWIs by low-pass filtered binary images pixel by pixel, and divided uncorrected T 1 -, T 2 -, or T 2 * -weighted images by those maps to obtain intensity-corrected images. We compared tissue contrast among the liver, spinal canal, and muscle between intensity-corrected multi-array coil images and volume coil images. Our intensity correction method performed well for all pulse sequences studied and corrected variation in original multi-array coil images without deteriorating the throughput of animal experiments. Tissue contrasts were comparable between intensity-corrected multi-array coil images and volume coil images. Our intensity correction method customized for multi-animal abdominal MR imaging using a 3T clinical scanner and dedicated multi-array coil could facilitate image interpretation. (author)

  4. Healthcare professionals' use of health clouds: Integrating technology acceptance and status quo bias perspectives.

    Science.gov (United States)

    Hsieh, Pi-Jung

    2015-07-01

    Cloud computing technology has recently been seen as an important milestone in medical informatics development. Despite its great potential, there are gaps in our understanding of how users evaluate change in relation to the health cloud and how they decide to resist it. Integrating technology acceptance and status quo bias perspectives, this study develops an integrated model to explain healthcare professionals' intention to use the health cloud service and their intention to resist it. A field survey was conducted in Taiwan to collect data from healthcare professionals; a structural equation model was used to examine the data. A valid sample of 209 healthcare professionals was collected for data analysis. The results show that healthcare professionals' resistance to the use of the health cloud is the result of regret avoidance, inertia, perceived value, switching costs, and perceived threat. Attitude, subjective norm, and perceived behavior control are shown to have positive and direct effects on healthcare professionals' intention to use the health cloud. The results also indicate a significant negative effect in the relationship between healthcare professionals' intention and resistance to using the health cloud. Our study illustrates the importance of incorporating user resistance in technology acceptance studies in general and in health technology usage studies in particular. This study also identifies key factors for practitioners and hospitals to make adoption decisions in relation to the health cloud. Further, the study provides a useful reference for future studies in this subject field. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  5. Finessing incivility: The professional socialisation experiences of student nurses' first clinical placement, a grounded theory.

    Science.gov (United States)

    Thomas, Juliet; Jinks, Annette; Jack, Barbara

    2015-12-01

    Clinical practice is where student nurses are socialised into a professional role and acquire the distinct behaviour, attitudes and values of the nursing profession. Getting it right at the outset can maximise the development of a professional identity and the transmission of robust value systems. To explore the impact of the first clinical placement on the professional socialisation of adult undergraduate student nurses in the United Kingdom. Data of a longitudinal qualitative nature were collected and analysed using grounded theory. First year student nurses in hospital ward placements comprising a rural District General Hospital and a large inner city Hospital kept daily unstructured diaries for six weeks. A total of 26 undergraduate adult student nurses were purposefully sampled between 2008 and 2010 before undertaking their initial clinical placement. Data collection and analysis used grounded theory and the key question asked of the diarists 'tell me what it is like to be a first year nurse on a first placement' was theoretically adjusted during constant comparison and as the theory emerged. Ethical approval and consent was obtained. The theory of finessing incivility comprises a conceptual framework depicting how student nurses deal with professional incivility during their initial clinical placement and sustain a student identity. Being disillusioned with their role as worker rather than learner yields a sense of 'status dislocation'. Despite needing professional benevolence, they remain altruistic and seek recompense from significant others to negotiate for learning opportunities and relocate their student status. Despite the stressful transition into clinical practice rather than 'fit in', the student nurses want to belong as learners. His or her own resilience to learn nursing and be a professional student maintains their resolve, their altruism and strengthens their existing values to be benevolent towards an indifferent profession. This behaviour

  6. Teaching and Assessing Professionalism in Medical Learners and Practicing Physicians

    Directory of Open Access Journals (Sweden)

    Paul S. Mueller

    2015-04-01

    Full Text Available Professionalism is a core competency of physicians. Clinical knowledge and skills (and their maintenance and improvement, good communication skills, and sound understanding of ethics constitute the foundation of professionalism. Rising from this foundation are behaviors and attributes of professionalism: accountability, altruism, excellence, and humanism, the capstone of which is professionalism. Patients, medical societies, and accrediting organizations expect physicians to be professional. Furthermore, professionalism is associated with better clinical outcomes. Hence, medical learners and practicing physicians should be taught and assessed for professionalism. A number of methods can be used to teach professionalism (e.g. didactic lectures, web-based modules, role modeling, reflection, interactive methods, etc.. Because of the nature of professionalism, no single tool for assessing it among medical learners and practicing physicians exists. Instead, multiple assessment tools must be used (e.g. multi-source feedback using 360-degree reviews, patient feedback, critical incident reports, etc.. Data should be gathered continuously throughout an individual’s career. For the individual learner or practicing physician, data generated by these tools can be used to create a “professionalism portfolio,” the totality of which represents a picture of the individual’s professionalism. This portfolio in turn can be used for formative and summative feedback. Data from professionalism assessments can also be used for developing professionalism curricula and generating research hypotheses. Health care leaders should support teaching and assessing professionalism at all levels of learning and practice and promote learning environments and institutional cultures that are consistent with professionalism precepts.

  7. Communication in Health Professions: A European consensus on inter- and multi-professional learning objectives in German.

    Science.gov (United States)

    Bachmann, Cadja; Kiessling, Claudia; Härtl, Anja; Haak, Rainer

    2016-01-01

    Communication is object of increasing attention in the health professions. Teaching communication competencies should already begin in undergraduate education or pre-registration training. The aim of this project was to translate the Health Professions Core Communication Curriculum (HPCCC), an English catalogue of learning objectives, into German to make its content widely accessible in the German-speaking countries. This catalogue lists 61 educational objectives and was agreed on by 121 international communication experts. A European reference framework for inter- and multi-professional curriculum development for communication in the health professions in German-speaking countries should be provided. The German version of the HPCCC was drafted by six academics and went through multiple revisions until consensus was reached. The learning objectives were paired with appropriate teaching and assessment tools drawn from the database of the teaching Committee of the European Association for Communication Health Care (tEACH). The HPCCC learning objectives are now available in German and can be applied for curriculum planning and development in the different German-speaking health professions, the educational objectives can also be used for inter-professional purposes. Examples for teaching methods and assessment tools are given for using and implementing the objectives. The German version of the HPCCC with learning objectives for communication in health professions can contribute significantly to inter- and multi-professional curriculum development in the health care professions in the German-speaking countries. Examples for teaching methods and assessment tools from the materials compiled by tEACH supplement the curricular content and provide suggestions for practical implementation of the learning objectives in teaching and assessment. The relevance of the German HPCCC to the processes of curriculum development for the various health professions and inter-professional

  8. INTEGRATED METHODOLOGY FOR PRODUCT PLANNING USING MULTI CRITERIA ANALYSIS

    Directory of Open Access Journals (Sweden)

    Tarun Soota

    2016-09-01

    Full Text Available Integrated approach to multi-criteria decision problems is proposed using quality function deployment and analytical network process. The objective of the work is to rationalize and improve the method of analyzing and interpreting customer needs and technical requirements. The methodology is used to determine, prioritize engineering requirements based on customer needs for development of best product. Framework allows decision maker to decompose a complex problem in a hierarchical structure to show relationship between objective and criteria. Multi-criteria decision modeling is used for extending the hierarchy process to both dependence and feedback. A case study on bikes is presented for the proposed model.

  9. A Qualitative Study Exploring Moral Distress Among Pediatric Resuscitation Team Clinicians: Challenges to Professional Integrity.

    Science.gov (United States)

    Thomas, Tessy A; Thammasitboon, Satid; Balmer, Dorene F; Roy, Kevin; McCullough, Laurence B

    2016-07-01

    Our study objectives were to explore moral distress among pediatric team clinicians within the context of resuscitation experiences, and determine whether there were any distinctively ethical perspectives on moral distress that could be conceptualized as challenges to professional integrity, rather than to previously described psychological responses of clinicians. Descriptive, exploratory qualitative study. A large tertiary pediatric academic hospital in Houston, TX. Twenty-five PICU resuscitation team clinicians were interviewed from December 2012 to April 2013. None. All clinicians reported experiencing moral distress during certain resuscitations. Twenty-one of 25 clinicians reflected and acknowledged that their sense of professional integrity had been challenged during those resuscitation events. Four main components of resuscitation experience that induced moral distress were identified: 1) experiences where there was lack of understanding of the big picture; 2) experiences where there was suboptimal team leadership; 3) experiences where there was variable meanings to the word "resuscitation"; and 4) experiences were there was uncertainty of role responsibility. The perception of moral distress exists among pediatric clinicians during resuscitations and could be conceptualized as challenges to professional integrity. This ethical framework offers an alternative approach to understanding and investigating the complex layers of moral distress.

  10. Teacher Professional Development for Technology Integration in a Primary School Learning Community

    Science.gov (United States)

    Liu, Shih-Hsiung

    2013-01-01

    Teacher professional development (TPD) can benefit teachers in classrooms. This study contributes to an understanding of TPD processes where there is sufficient technology integration through teacher participation in a school-based community. It assesses the effectiveness of TPD and its potential problems. Qualitative research methods are used to…

  11. A web-based communication system for integrated care in cerebral palsy: experienced contribution to parent-professional communication

    NARCIS (Netherlands)

    Gulmans, Jitske; Vollenbroek-Hutten, Miriam Marie Rosé; van Gemert-Pijnen, Julia E.W.C.; van Harten, Wim H.; van Harten, Willem H.

    2012-01-01

    Introduction: to improve communication in the integrated care setting of children with cerebral palsy, we developed a web-based system for parent-professional and inter-professional communication. The present study aimed to evaluate parents' experiences regarding the system's contribution to their

  12. An Innovative Program to Support Internationally Educated Health Professionals and Their Instructors: Role of the Clinical Practice Facilitator.

    Science.gov (United States)

    Daniel, Sylvia; Lee, Annemarie L; Switzer-McIntyre, Sharon; Evans, Cathy

    2016-01-01

    Internationally educated health professionals immigrating to other countries may experience difficulty in clinical practice, due to linguistic and cultural factors. An important element of bridging is the opportunity for internationally educated health professionals to practice in a clinical environment. To support these health professionals and their clinical instructors, a Clinical Practice Facilitator (CPF) role was created. This study aimed to examine the CPF from internationally educated health professionals and clinical instructors' perspective. A quantitative survey was conducted with two cohorts (2013 and 2015) of internationally educated physical therapists and clinical instructors who were asked about the nature of interaction with CPFs, mentor, and education roles and the benefits and challenges of the role. Thirty-five internationally educated physical therapists and 37 clinical instructors participated and were satisfied with the interaction with CPFs via face-to-face or e-mail communication. There was strong agreement (>80%) that the CPF educator role was to facilitate learner's reflection on clinical practice while the mentor role (>70%) was to answer questions, provide feedback, and investigate clinical concerns and conflicts. There was insufficient time for access to CPFs and resolution of learners' learning needs. There were differences (P = 0.04) in perspective on the benefit of the CPF in assisting with cultural differences. An innovative CPF role provided support encouragement, clinical, and professional advice. There were discordant views regarding the benefits of the CPF role in addressing cultural issues, which requires further examination.

  13. [Multi-facetted clinical presentation of thrombotic thrombocytopenic purpura

    DEFF Research Database (Denmark)

    Niemann, C.U.; Jurlander, J.; Daugaard, G.

    2009-01-01

    smears. Determination of the ADAMTS13-activity is now becoming available as a routine analysis. We present two cases that illustrate the multi-facetted clinical presentation under which TTP occurs. The importance of access to ADAMTS13 measurements is stressed Udgivelsesdato: 2009/1/26...

  14. The feasibility, perceived satisfaction, and value of using synchronous webinars to educate clinical research professionals on reporting adverse events in clinical trials: a report from the Children's Oncology Group.

    Science.gov (United States)

    Borgerson, Dawn; Dino, Jennifer

    2012-01-01

    Clinical research professionals are faced with decreased funding and increased workloads; innovative methods of professional development programs are necessary to accommodate these factors. This study evaluated the feasibility, perceived satisfaction, and value of using webinars to educate clinical research professionals on reporting adverse events commonly experienced in pediatric oncology clinical trials. The setting incorporated synchronous web-based educational technology. Constructivist learning provides the theoretical framework for this study. Participants evaluated the professional development program at 2 time points: (a) at the conclusion and (b) 4 to 6 weeks afterward, using survey method. Synchronous webinars were both economical and effective in educating clinical research professionals across institutional sites. Participants reported exceptionally high levels of satisfaction with the accessibility, scope, quality, and interactivity of the professional development program. The vast majority of participants reported that the education would assist with reporting adverse events in pediatric oncology clinical trials and this perception persisted into clinical practice. Although the results of this study were intended to guide future educational efforts of the Children's Oncology Group, they may also apply to other cooperative groups.

  15. Design and implementation of space physics multi-model application integration based on web

    Science.gov (United States)

    Jiang, Wenping; Zou, Ziming

    With the development of research on space environment and space science, how to develop network online computing environment of space weather, space environment and space physics models for Chinese scientific community is becoming more and more important in recent years. Currently, There are two software modes on space physics multi-model application integrated system (SPMAIS) such as C/S and B/S. the C/S mode which is traditional and stand-alone, demands a team or workshop from many disciplines and specialties to build their own multi-model application integrated system, that requires the client must be deployed in different physical regions when user visits the integrated system. Thus, this requirement brings two shortcomings: reducing the efficiency of researchers who use the models to compute; inconvenience of accessing the data. Therefore, it is necessary to create a shared network resource access environment which could help users to visit the computing resources of space physics models through the terminal quickly for conducting space science research and forecasting spatial environment. The SPMAIS develops high-performance, first-principles in B/S mode based on computational models of the space environment and uses these models to predict "Space Weather", to understand space mission data and to further our understanding of the solar system. the main goal of space physics multi-model application integration system (SPMAIS) is to provide an easily and convenient user-driven online models operating environment. up to now, the SPMAIS have contained dozens of space environment models , including international AP8/AE8 IGRF T96 models and solar proton prediction model geomagnetic transmission model etc. which are developed by Chinese scientists. another function of SPMAIS is to integrate space observation data sets which offers input data for models online high-speed computing. In this paper, service-oriented architecture (SOA) concept that divides system into

  16. Integrated multi-trophic aquaculture (combined production of fish, mussels and seaweed)

    DEFF Research Database (Denmark)

    Holdt, Susan Løvstad; Silva Marinho, Goncalo; Angelidaki, Irini

    2014-01-01

    The Danish marine aquaculture has, despite the huge potential, only been slowly increasing the last 25 years because of the imposed limits to the nitrogen (N) released to the environment. Mussels, seaweed and other organisms have been successfully tested as biofilters in integrated multi-trophic ......The Danish marine aquaculture has, despite the huge potential, only been slowly increasing the last 25 years because of the imposed limits to the nitrogen (N) released to the environment. Mussels, seaweed and other organisms have been successfully tested as biofilters in integrated multi......, mineral and vitamin content and profiles were monitored to evaluate the nutritional value and harvest time of the seaweed biomass. Sugarkelp showed to be efficient for bioremediation of nitrogen, with environmental and potentially economic benefits (e.g. waste water management and for production...

  17. A systematic and efficient method to compute multi-loop master integrals

    Science.gov (United States)

    Liu, Xiao; Ma, Yan-Qing; Wang, Chen-Yu

    2018-04-01

    We propose a novel method to compute multi-loop master integrals by constructing and numerically solving a system of ordinary differential equations, with almost trivial boundary conditions. Thus it can be systematically applied to problems with arbitrary kinematic configurations. Numerical tests show that our method can not only achieve results with high precision, but also be much faster than the only existing systematic method sector decomposition. As a by product, we find a new strategy to compute scalar one-loop integrals without reducing them to master integrals.

  18. 3D-MICE: integration of cross-sectional and longitudinal imputation for multi-analyte longitudinal clinical data.

    Science.gov (United States)

    Luo, Yuan; Szolovits, Peter; Dighe, Anand S; Baron, Jason M

    2018-06-01

    A key challenge in clinical data mining is that most clinical datasets contain missing data. Since many commonly used machine learning algorithms require complete datasets (no missing data), clinical analytic approaches often entail an imputation procedure to "fill in" missing data. However, although most clinical datasets contain a temporal component, most commonly used imputation methods do not adequately accommodate longitudinal time-based data. We sought to develop a new imputation algorithm, 3-dimensional multiple imputation with chained equations (3D-MICE), that can perform accurate imputation of missing clinical time series data. We extracted clinical laboratory test results for 13 commonly measured analytes (clinical laboratory tests). We imputed missing test results for the 13 analytes using 3 imputation methods: multiple imputation with chained equations (MICE), Gaussian process (GP), and 3D-MICE. 3D-MICE utilizes both MICE and GP imputation to integrate cross-sectional and longitudinal information. To evaluate imputation method performance, we randomly masked selected test results and imputed these masked results alongside results missing from our original data. We compared predicted results to measured results for masked data points. 3D-MICE performed significantly better than MICE and GP-based imputation in a composite of all 13 analytes, predicting missing results with a normalized root-mean-square error of 0.342, compared to 0.373 for MICE alone and 0.358 for GP alone. 3D-MICE offers a novel and practical approach to imputing clinical laboratory time series data. 3D-MICE may provide an additional tool for use as a foundation in clinical predictive analytics and intelligent clinical decision support.

  19. Email for clinical communication between patients/caregivers and healthcare professionals.

    Science.gov (United States)

    Atherton, Helen; Sawmynaden, Prescilla; Sheikh, Aziz; Majeed, Azeem; Car, Josip

    2012-11-14

    Email is a popular and commonly-used method of communication, but its use in health care is not routine. Where email communication has been demonstrated in health care this has included its use for communication between patients/caregivers and healthcare professionals for clinical purposes, but the effects of using email in this way is not known.This review addresses the use of email for two-way clinical communication between patients/caregivers and healthcare professionals. To assess the effects of healthcare professionals and patients using email to communicate with each other, on patient outcomes, health service performance, service efficiency and acceptability. We searched: the Cochrane Consumers and Communication Review Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1 2010), MEDLINE (OvidSP) (1950 to January 2010), EMBASE (OvidSP) (1980 to January 2010), PsycINFO (OvidSP) (1967 to January 2010), CINAHL (EbscoHOST) (1982 to February 2010) and ERIC (CSA) (1965 to January 2010). We searched grey literature: theses/dissertation repositories, trials registers and Google Scholar (searched July 2010). We used additional search methods: examining reference lists, contacting authors. Randomised controlled trials, quasi-randomised trials, controlled before and after studies and interrupted time series studies examining interventions using email to allow patients to communicate clinical concerns to a healthcare professional and receive a reply, and taking the form of 1) unsecured email 2) secure email or 3) web messaging. All healthcare professionals, patients and caregivers in all settings were considered. Two authors independently assessed the risk of bias of included studies and extracted data. We contacted study authors for additional information. We assessed risk of bias according to the Cochrane Handbook for Systematic Reviews of Interventions. For continuous measures, we report effect sizes as mean

  20. A Reconfigurable Readout Integrated Circuit for Heterogeneous Display-Based Multi-Sensor Systems

    Directory of Open Access Journals (Sweden)

    Kyeonghwan Park

    2017-04-01

    Full Text Available This paper presents a reconfigurable multi-sensor interface and its readout integrated circuit (ROIC for display-based multi-sensor systems, which builds up multi-sensor functions by utilizing touch screen panels. In addition to inherent touch detection, physiological and environmental sensor interfaces are incorporated. The reconfigurable feature is effectively implemented by proposing two basis readout topologies of amplifier-based and oscillator-based circuits. For noise-immune design against various noises from inherent human-touch operations, an alternate-sampling error-correction scheme is proposed and integrated inside the ROIC, achieving a 12-bit resolution of successive approximation register (SAR of analog-to-digital conversion without additional calibrations. A ROIC prototype that includes the whole proposed functions and data converters was fabricated in a 0.18 μm complementary metal oxide semiconductor (CMOS process, and its feasibility was experimentally verified to support multiple heterogeneous sensing functions of touch, electrocardiogram, body impedance, and environmental sensors.

  1. The KNOMAD Methodology for Integration of Multi-Disciplinary Engineering Knowledge within Aerospace Production

    NARCIS (Netherlands)

    Curran, R.; Verhagen, W.J.C.; Van Tooren, M.J.L.

    2010-01-01

    The paper is associated with the integration of multi-disciplinary knowledge within a Knowledge Based Engineering (KBE)-enabled design framework. To support this integration effort, the KNOMAD methodology has been devised. KNOMAD stands for Knowledge Optimized Manufacture And Design and is a

  2. Integration of Advanced Probabilistic Analysis Techniques with Multi-Physics Models

    Energy Technology Data Exchange (ETDEWEB)

    Cetiner, Mustafa Sacit; none,; Flanagan, George F. [ORNL; Poore III, Willis P. [ORNL; Muhlheim, Michael David [ORNL

    2014-07-30

    An integrated simulation platform that couples probabilistic analysis-based tools with model-based simulation tools can provide valuable insights for reactive and proactive responses to plant operating conditions. The objective of this work is to demonstrate the benefits of a partial implementation of the Small Modular Reactor (SMR) Probabilistic Risk Assessment (PRA) Detailed Framework Specification through the coupling of advanced PRA capabilities and accurate multi-physics plant models. Coupling a probabilistic model with a multi-physics model will aid in design, operations, and safety by providing a more accurate understanding of plant behavior. This represents the first attempt at actually integrating these two types of analyses for a control system used for operations, on a faster than real-time basis. This report documents the development of the basic communication capability to exchange data with the probabilistic model using Reliability Workbench (RWB) and the multi-physics model using Dymola. The communication pathways from injecting a fault (i.e., failing a component) to the probabilistic and multi-physics models were successfully completed. This first version was tested with prototypic models represented in both RWB and Modelica. First, a simple event tree/fault tree (ET/FT) model was created to develop the software code to implement the communication capabilities between the dynamic-link library (dll) and RWB. A program, written in C#, successfully communicates faults to the probabilistic model through the dll. A systems model of the Advanced Liquid-Metal Reactor–Power Reactor Inherently Safe Module (ALMR-PRISM) design developed under another DOE project was upgraded using Dymola to include proper interfaces to allow data exchange with the control application (ConApp). A program, written in C+, successfully communicates faults to the multi-physics model. The results of the example simulation were successfully plotted.

  3. An integrated multi-stage supply chain inventory model with imperfect production process

    Directory of Open Access Journals (Sweden)

    Soumita Kundu

    2015-09-01

    Full Text Available This paper deals with an integrated multi-stage supply chain inventory model with the objective of cost minimization by synchronizing the replenishment decisions for procurement, production and delivery activities. The supply chain structure examined here consists of a single manufacturer with multi-buyer where manufacturer orders a fixed quantity of raw material from outside suppliers, processes the materials and delivers the finished products in unequal shipments to each customer. In this paper, we consider an imperfect production system, which produces defective items randomly and assumes that all defective items could be reworked. A simple algorithm is developed to obtain an optimal production policy, which minimizes the expected average total cost of the integrated production-inventory system.

  4. Opinions of professionals about integrating midwife- and obstetrician-led care in The Netherlands

    NARCIS (Netherlands)

    Perdok, H.; Jans, S.; Verhoeven, C.; Dillen, J. van; Batenburg, R.S.; Mol, B.W.; Schellevis, F.; Jonge, A. de

    2016-01-01

    OBJECTIVE: the current division between midwife-led and obstetrician-led care creates fragmentation in maternity care in the Netherlands. This study aims to gain insight into the level of consensus among maternity care professionals about facilitators and barriers related to integration of

  5. Opinions of professionals about integrating midwife- and obstetrician-led care in The Netherlands.

    NARCIS (Netherlands)

    Perdok, H.; Jans, S.; Verhoeven, C.; Dillen C.; Batenburg, R.; Mol, B.W.; Schellevis, F.; Jonge, A. de

    2016-01-01

    Objective: the current division between midwife-led and obstetrician-led care creates fragmentation in maternity care in the Netherlands. This study aims to gain insight into the level of consensus among maternity care professionals about facilitators and barriers related to integration of

  6. Erosion of Digital Professionalism During Medical Students' Core Clinical Clerkships.

    Science.gov (United States)

    Mostaghimi, Arash; Olszewski, Aleksandra E; Bell, Sigall K; Roberts, David H; Crotty, Bradley H

    2017-05-03

    The increased use of social media, cloud computing, and mobile devices has led to the emergence of guidelines and novel teaching efforts to guide students toward the appropriate use of technology. Despite this, violations of professional conduct are common. We sought to explore professional behaviors specific to appropriate use of technology by looking at changes in third-year medical students' attitudes and behaviors at the beginning and conclusion of their clinical clerkships. After formal teaching about digital professionalism, we administered a survey to medical students that described 35 technology-related behaviors and queried students about professionalism of the behavior (on a 5-point Likert scale), observation of others engaging in the behavior (yes or no), as well as personal participation in the behavior (yes or no). Students were resurveyed at the end of the academic year. Over the year, perceptions of what is considered acceptable behavior regarding privacy, data security, communications, and social media boundaries changed, despite formal teaching sessions to reinforce professional behavior. Furthermore, medical students who observed unprofessional behaviors were more likely to participate in such behaviors. Although technology is a useful tool to enhance teaching and learning, our results reflect an erosion of professionalism related to information security that occurred despite medical school and hospital-based teaching sessions to promote digital professionalism. True alteration of trainee behavior will require a cultural shift that includes continual education, better role models, and frequent reminders for faculty, house staff, students, and staff. ©Arash Mostaghimi, Aleksandra E Olszewski, Sigall K Bell, David H Roberts, Bradley H Crotty. Originally published in JMIR Medical Education (http://mededu.jmir.org), 03.05.2017.

  7. Hospital-physician collaboration: landscape of economic integration and impact on clinical integration.

    Science.gov (United States)

    Burns, Lawton Robert; Muller, Ralph W

    2008-09-01

    Hospital-physician relationships (HPRs) are an important area of academic research, given their impact on hospitals' financial success. HPRs also are at the center of several federal policy proposals such as gain sharing, bundled payments, and pay-for-performance (P4P). This article analyzes the HPRs that focus on the economic integration of hospitals and physicians and the goals that HPRs are designed to achieve. It then reviews the literature on the impact of HPRs on cost, quality, and clinical integration. The goals of the two parties in HPRs overlap only partly, and their primary aim is not reducing cost or improving quality. The evidence base for the impact of many models of economic integration is either weak or nonexistent, with only a few models of economic integration having robust effects. The relationship between economic and clinical integration also is weak and inconsistent. There are several possible reasons for this weak linkage and many barriers to further integration between hospitals and physicians. Successful HPRs may require better financial conditions for physicians, internal changes to clinical operations, application of behavioral skills to the management of HPRs, changes in how providers are paid, and systemic changes encompassing several types of integration simultaneously.

  8. [Implementing Inter-Professional Education (IPE): Challenges and Strategies].

    Science.gov (United States)

    Lee, Chia-Lun; Hung, Chich-Hsiu

    2017-12-01

    Inter-professional practice (IPP), necessary in today's healthcare environment, should be guided and practiced through inter-professional education (IPE). Within the context of an effective IPE program, collaborative medical professionals must be cognizant of the demands of patients' integrated care, organize a collaborative inter-professional team, and achieve the objectives of patient-centered care. However, the many challenges of IPE include insufficient understanding of inter-professional care, occupational culture-related boundary issues, lack of a college education, and insufficient support from academic and medical institutions. This article suggests adopting effective strategies to promote inter-professional recognition, create a harmonious medical culture, eliminate barriers to education, and enhance support for academic and medical institutions. Inter-professional collaboration between academic and clinical institutions must provide resources and substantive professional training. Effectively implementing IPE and IPP is expected to elicit trust, respect, and efficient communication from team members.

  9. Skills in clinical communication: Are we correctly assessing them at undergraduate level?

    Directory of Open Access Journals (Sweden)

    Alberto Zamora Cervantes

    2014-07-01

    Full Text Available Communicating with the patient in clinical practice refers to the way in which the doctor and the patient interact both verbally and nonverbally, in order to achieve a shared understanding of problems and solutions. Traditional learning and assessment systems are overwhelmed when it comes to addressing the complex and multi-dimensional problems of professional practice. Problem Based Learning (PBL has been put forward as an alternative to the mere reproduction of knowledge and pre-established patterns, enabling students to develop their own learning strategies to overcome problems in their future professional practice. The challenge is to determine how to assess the acquisition of clinical communication skills. The authors have recommended a summative assessment of clinical communication skills based on the combination of different methods. It highlights the importance of feedback-based formative assessment. This raises the need to develop and validate assessment scales in clinical communication at an undergraduate level. Based on this work, the authors put forward a "fanned out" assessment in terms of clinical communication skills in Medicine degrees, with the use of different instruments in a "spiraled" manner, where the greater the contact with clinical practice in the various degree and integral courses, the greater difficulty experienced, with the participation of all the stakeholders involved (self, hetero and peer assessment without precluding the involvement of patients (real or simulated in the design of assessment instruments.

  10. [A web-based integrated clinical database for laryngeal cancer].

    Science.gov (United States)

    E, Qimin; Liu, Jialin; Li, Yong; Liang, Chuanyu

    2014-08-01

    To establish an integrated database for laryngeal cancer, and to provide an information platform for laryngeal cancer in clinical and fundamental researches. This database also meet the needs of clinical and scientific use. Under the guidance of clinical expert, we have constructed a web-based integrated clinical database for laryngeal carcinoma on the basis of clinical data standards, Apache+PHP+MySQL technology, laryngeal cancer specialist characteristics and tumor genetic information. A Web-based integrated clinical database for laryngeal carcinoma had been developed. This database had a user-friendly interface and the data could be entered and queried conveniently. In addition, this system utilized the clinical data standards and exchanged information with existing electronic medical records system to avoid the Information Silo. Furthermore, the forms of database was integrated with laryngeal cancer specialist characteristics and tumor genetic information. The Web-based integrated clinical database for laryngeal carcinoma has comprehensive specialist information, strong expandability, high feasibility of technique and conforms to the clinical characteristics of laryngeal cancer specialties. Using the clinical data standards and structured handling clinical data, the database can be able to meet the needs of scientific research better and facilitate information exchange, and the information collected and input about the tumor sufferers are very informative. In addition, the user can utilize the Internet to realize the convenient, swift visit and manipulation on the database.

  11. A systematic and efficient method to compute multi-loop master integrals

    Directory of Open Access Journals (Sweden)

    Xiao Liu

    2018-04-01

    Full Text Available We propose a novel method to compute multi-loop master integrals by constructing and numerically solving a system of ordinary differential equations, with almost trivial boundary conditions. Thus it can be systematically applied to problems with arbitrary kinematic configurations. Numerical tests show that our method can not only achieve results with high precision, but also be much faster than the only existing systematic method sector decomposition. As a by product, we find a new strategy to compute scalar one-loop integrals without reducing them to master integrals.

  12. Multi-sensor integration for autonomous robots in nuclear power plants

    International Nuclear Information System (INIS)

    Mann, R.C.; Jones, J.P.; Beckerman, M.; Glover, C.W.; Farkas, L.; Bilbro, G.L.; Snyder, W.

    1989-01-01

    As part of a concerted RandD program in advanced robotics for hazardous environments, scientists and engineers at the Oak Ridge National Laboratory (ORNL) are performing research in the areas of systems integration, range-sensor-based 3-D world modeling, and multi-sensor integration. This program features a unique teaming arrangement that involves the universities of Florida, Michigan, Tennessee, and Texas; Odetics Corporation; and ORNL. This paper summarizes work directed at integrating information extracted from data collected with range sensors and CCD cameras on-board a mobile robot, in order to produce reliable descriptions of the robot's environment. Specifically, the paper describes the integration of two-dimensional vision and sonar range information, and an approach to integrate registered luminance and laser range images. All operations are carried out on-board the mobile robot using a 16-processor hypercube computer. 14 refs., 4 figs

  13. Measuring multi-membership in economic integration and its trade-impact. A comparative study of ECOWAS and SADC

    DEFF Research Database (Denmark)

    Afesorgbor, Sylvanus Kwaku; van Bergeijk, Peter A.G.

    in two major African Regional blocs, ECOWAS and SADC. We find that the impact of multi-membership critically depends on the characteristics of the multi-membership of regional integration initiatives. We find a positive impact if an additional membership complements the integration process...... of the original regional integration initiative: overlapping memberships had a much stronger and significant positive effect on bilateral trade within ECOWAS compare to an insignificant impact within SADC....

  14. Neither Right nor Wrong: How a Teacher Integrates Her Personal and Professional Life with Policy

    Science.gov (United States)

    Bunten, Bridget A.

    2014-01-01

    This article focuses on the importance of recognizing and appreciating the ways that a teacher integrates her personal and professional life with an English-only policy. Much can be learned from the ways in which she negotiates social forces and integrates them into her individual reality while making sense of the restrictive language policy.…

  15. A multi-structural and multi-functional integrated fog collection system in cactus.

    Science.gov (United States)

    Ju, Jie; Bai, Hao; Zheng, Yongmei; Zhao, Tianyi; Fang, Ruochen; Jiang, Lei

    2012-01-01

    Multiple biological structures have demonstrated fog collection abilities, such as beetle backs with bumps and spider silks with periodic spindle-knots and joints. Many Cactaceae species live in arid environments and are extremely drought-tolerant. Here we report that one of the survival systems of the cactus Opuntia microdasys lies in its efficient fog collection system. This unique system is composed of well-distributed clusters of conical spines and trichomes on the cactus stem; each spine contains three integrated parts that have different roles in the fog collection process according to their surface structural features. The gradient of the Laplace pressure, the gradient of the surface-free energy and multi-function integration endow the cactus with an efficient fog collection system. Investigations of the structure-function relationship in this system may help us to design novel materials and devices to collect water from fog with high efficiencies.

  16. A multi-structural and multi-functional integrated fog collection system in cactus

    Science.gov (United States)

    Ju, Jie; Bai, Hao; Zheng, Yongmei; Zhao, Tianyi; Fang, Ruochen; Jiang, Lei

    2012-01-01

    Multiple biological structures have demonstrated fog collection abilities, such as beetle backs with bumps and spider silks with periodic spindle-knots and joints. Many Cactaceae species live in arid environments and are extremely drought-tolerant. Here we report that one of the survival systems of the cactus Opuntia microdasys lies in its efficient fog collection system. This unique system is composed of well-distributed clusters of conical spines and trichomes on the cactus stem; each spine contains three integrated parts that have different roles in the fog collection process according to their surface structural features. The gradient of the Laplace pressure, the gradient of the surface-free energy and multi-function integration endow the cactus with an efficient fog collection system. Investigations of the structure–function relationship in this system may help us to design novel materials and devices to collect water from fog with high efficiencies. PMID:23212376

  17. Theory-practice integration in selected clinical situations

    Directory of Open Access Journals (Sweden)

    M Davhana-Maselesele

    2001-09-01

    Full Text Available The current changes in health care systems challenge knowledgeable, mature and independent practitioners to integrate theoretical content with practice. The aim of this study was to investigate the problems of integrating theory with practice in selected clinical nursing situations. The study focused on rendering of family planning services to clients as a component of Community Nursing Science. Structured observation schedules were used to observe the theoretical content of the curriculum as well as the practical application of what has been taught in the clinical area. The findings of the study revealed that there was a need for an integrated holistic curriculum, which would address the needs of the community. It was concluded that a problem-based and community-based curriculum, intersectoral collaboration between college and hospital managements and student involvement in all processes of teaching and learning would improve the integration of theory and practice. There also appeared to be a need for tutors to be more involved in clinical teaching and accompaniment.

  18. Medication therapy management clinic: perception of healthcare professionals in a University medical center setting

    Directory of Open Access Journals (Sweden)

    Shah M

    2013-09-01

    Full Text Available Objective: To determine the overall perception and utilization of the pharmacist managed medication therapy management (MTM clinic services, by healthcare professionals in a large, urban, university medical care setting.Methods: This was a cross-sectional, anonymous survey sent to 195 healthcare professionals, including physicians, nurses, and pharmacists at The University of Illinois Outpatient Care Center to determine their perception and utilization of the MTM clinic. The survey consisted of 12 questions and was delivered through a secure online application. Results: Sixty-two healthcare professionals (32% completed the survey. 82% were familiar with the MTM clinic, and 63% had referred patients to the clinic. Medication adherence and disease state management was the most common reason for referral. Lack of knowledge on the appropriate referral procedure was the prominent reason for not referring patients to the MTM clinic. Of the providers that were aware of MTM services, 44% rated care as ‘excellent’, 44% as ‘good’, 5% as ‘fair’, and 0% stated ‘poor’. Strengths of MTM clinic identified by healthcare providers included in-depth education to patients, close follow-up, and detailed medication reconciliation provided by MTM clinic pharmacists. Of those familiar with MTM clinic, recommendations included; increase marketing efforts to raise awareness of the MTM clinic service, create collaborative practice agreements between MTM pharmacists and physicians, and ensure that progress notes are more concise.Conclusion: In a large, urban, academic institution MTM clinic is perceived as a valuable resource to optimize patient care by providing patients with in-depth education as it relates to their prescribed medications and disease states. These identified benefits of MTM clinic lead to frequent patient referrals specifically for aid with medication adherence and disease state management.

  19. Do patients and health care professionals view the communication processes of clinical research differently? A Rasch analysis from a survey.

    Science.gov (United States)

    González-de Paz, Luis; Kostov, Belchin; Solans-Julian, Pilar; Navarro-Rubio, M Dolores; Sisó-Almirall, Antoni

    2015-10-01

    The increasing amount of the clinical research conducted in the primary health care has enabled extending research beyond traditional settings, but this transfer has implied some trade-offs. Health care professionals who conduct research with trusted patients require assuming the ethical standards of research and communication skills to enable patients' autonomy and freedom of choice. This study aims to measure the opinions of health professionals and patients on issues of communication in clinical research. A cross-sectional study with health care professionals and patients from primary health care centres in Barcelona (Spain). Each group completed a similar self-administered questionnaire. A Rasch model was fitted to data. After examination of goodness-of-fit, differences between groups were compared using analysis of variance, and patients' measures were calibrated to professionals' measures to compare overall mean measures. Professionals and patients found the ethical attitudes most difficult to endorse related to trust in clinical researchers and conflicts of interest. Patients' perceptions of professional ethical behaviour were significantly lower than professionals'. Different item functioning between nurses and family doctors was found in the item on seeking ethical collaboration when collaborating in clinical research. Effective knowledge of ethical norms was associated with greater perceived ethical values in clinical research and confidence in health care professionals among patients. Differences in the views of the communication process between patients and professionals could alert research boards, health care institutions and researchers to the need for greater transparency, trust and ethical instruction when patients are involved in clinical research. © 2015 John Wiley & Sons, Ltd.

  20. Physicians’ Professionally Responsible Power: A Core Concept of Clinical Ethics

    Science.gov (United States)

    McCullough, Laurence B.

    2016-01-01

    The gathering of power unto themselves by physicians, a process supported by evidence-based practice, clinical guidelines, licensure, organizational culture, and other social factors, makes the ethics of power—the legitimation of physicians’ power—a core concept of clinical ethics. In the absence of legitimation, the physician’s power over patients becomes problematic, even predatory. As has occurred in previous issues of the Journal, the papers in the 2016 clinical ethics issue bear on the professionally responsible deployment of power by physicians. This introduction explores themes of physicians’ power in papers from an international group of authors who address autonomy and trust, the virtues of perinatal hospice, conjoined twins in ethics and law, addiction and autonomy in clinical research on addicting substances, euthanasia of patients with dementia in Belgium, and a pragmatic approach to clinical futility. PMID:26671961

  1. Clinical application of multi-shot diffusion EPI in neurological disease

    International Nuclear Information System (INIS)

    Ishihara, Tetsuya; Hirata, Koichi; Kubo, Jin; Yamazaki, Kaoru; Sato, Toshihiko

    1998-01-01

    Using the multi-shot EPI method we investigated the clinical application of diffusion weighted imaging (DWI) in the diagnosis of neurological disease. The multi-shot method provided better susceptibility artifact-free DWI than the single-shot method particularly in the region of the posterior cranial fossa. DWI using the multi-shot EPI method readily shows the pyramidal tract extending from the internal capsule to the brainstems which is inaccessible by the conventional single-shot EPI method, and providing three-dimensional and distinct images of pyramidal tract changes in amyotrophic lateral sclerosis or cerebral infarction with pyramidal tract disturbance. Our findings suggest that the use of DWI with the multi-shot EPI method would provide a technique for the easy diagnosis and evaluation of various neurological diseases. (author)

  2. Clinical application of multi-shot diffusion EPI in neurological disease

    Energy Technology Data Exchange (ETDEWEB)

    Ishihara, Tetsuya; Hirata, Koichi; Kubo, Jin; Yamazaki, Kaoru [Dokkyo Univ., Mibu, Tochigi (Japan). School of Medicine; Sato, Toshihiko

    1998-05-01

    Using the multi-shot EPI method we investigated the clinical application of diffusion weighted imaging (DWI) in the diagnosis of neurological disease. The multi-shot method provided better susceptibility artifact-free DWI than the single-shot method particularly in the region of the posterior cranial fossa. DWI using the multi-shot EPI method readily shows the pyramidal tract extending from the internal capsule to the brainstems which is inaccessible by the conventional single-shot EPI method, and providing three-dimensional and distinct images of pyramidal tract changes in amyotrophic lateral sclerosis or cerebral infarction with pyramidal tract disturbance. Our findings suggest that the use of DWI with the multi-shot EPI method would provide a technique for the easy diagnosis and evaluation of various neurological diseases. (author)

  3. Development of a formative assessment tool for measurement of performance in multi-professional resuscitation teams

    DEFF Research Database (Denmark)

    Andersen, Peter Oluf; Jensen, Michael Kammer; Lippert, Anne

    2010-01-01

    Treating cardiac arrest is linked to the mutual performance of several health-care individuals' task coordination. Non-technical skills, including communication, leadership and team interaction, could improve sequencing the tasks in the cardiac arrest algorithm. Non-technical skills have been...... a part of crew resource management training, created to improve safety in aviation. This study aimed, first, to establish crew resource management and non-technical skill-based learning objectives and behavioural markers for the performance of multi-professional resuscitation teams; second, to develop...

  4. CER Hub: An informatics platform for conducting comparative effectiveness research using multi-institutional, heterogeneous, electronic clinical data.

    Science.gov (United States)

    Hazlehurst, Brian L; Kurtz, Stephen E; Masica, Andrew; Stevens, Victor J; McBurnie, Mary Ann; Puro, Jon E; Vijayadeva, Vinutha; Au, David H; Brannon, Elissa D; Sittig, Dean F

    2015-10-01

    Comparative effectiveness research (CER) requires the capture and analysis of data from disparate sources, often from a variety of institutions with diverse electronic health record (EHR) implementations. In this paper we describe the CER Hub, a web-based informatics platform for developing and conducting research studies that combine comprehensive electronic clinical data from multiple health care organizations. The CER Hub platform implements a data processing pipeline that employs informatics standards for data representation and web-based tools for developing study-specific data processing applications, providing standardized access to the patient-centric electronic health record (EHR) across organizations. The CER Hub is being used to conduct two CER studies utilizing data from six geographically distributed and demographically diverse health systems. These foundational studies address the effectiveness of medications for controlling asthma and the effectiveness of smoking cessation services delivered in primary care. The CER Hub includes four key capabilities: the ability to process and analyze both free-text and coded clinical data in the EHR; a data processing environment supported by distributed data and study governance processes; a clinical data-interchange format for facilitating standardized extraction of clinical data from EHRs; and a library of shareable clinical data processing applications. CER requires coordinated and scalable methods for extracting, aggregating, and analyzing complex, multi-institutional clinical data. By offering a range of informatics tools integrated into a framework for conducting studies using EHR data, the CER Hub provides a solution to the challenges of multi-institutional research using electronic medical record data. Copyright © 2015. Published by Elsevier Ireland Ltd.

  5. Development of multi-channel gated integrator and PXI-DAQ system for nuclear detector arrays

    International Nuclear Information System (INIS)

    Kong Jie; Su Hong; Chen Zhiqiang; Dong Chengfu; Qian Yi; Gao Shanshan; Zhou Chaoyang; Lu Wan; Ye Ruiping; Ma Junbing

    2010-01-01

    A multi-channel gated integrator and PXI based data acquisition system have been developed for nuclear detector arrays with hundreds of detector units. The multi-channel gated integrator can be controlled by a programmable GI controller. The PXI-DAQ system consists of NI PXI-1033 chassis with several PXI-DAQ cards. The system software has a user-friendly GUI which is written in C language using LabWindows/CVI under Windows XP operating system. The performance of the PXI-DAQ system is very reliable and capable of handling event rate up to 40 kHz.

  6. Training Needs of Clinical and Research Professionals to Optimize Minority Recruitment and Retention in Cancer Clinical Trials.

    Science.gov (United States)

    Niranjan, Soumya J; Durant, Raegan W; Wenzel, Jennifer A; Cook, Elise D; Fouad, Mona N; Vickers, Selwyn M; Konety, Badrinath R; Rutland, Sarah B; Simoni, Zachary R; Martin, Michelle Y

    2017-08-03

    The study of disparities in minority recruitment to cancer clinical trials has focused primarily on inquiries among minority patient populations. However, clinical trial recruitment is complex and requires a broader appreciation of the multiple factors that influence minority participation. One area that has received little attention is minority recruitment training for professionals who assume various roles in the clinical trial recruitment process. Therefore, we assessed the perspectives of cancer center clinical and research personnel on their training and education needs toward minority recruitment for cancer clinical trials. Ninety-one qualitative interviews were conducted at five U.S. cancer centers among four stakeholder groups: cancer center leaders, principal investigators, referring clinicians, and research staff. Interviews were recorded and transcribed. Qualitative analyses focused on response data related to training for minority recruitment for cancer clinical trials. Four prominent themes were identified: (1) Research personnel are not currently being trained to focus on recruitment and retention of minority populations; (2) Training for minority recruitment and retention provides for a specific focus on factors influencing minority research participation; (3) Training on cultural awareness may help to bridge cultural gaps between potential minority participants and research professionals; (4) Views differ regarding the importance of research personnel training designed to focus on recruitment of minority populations. There is a lack of systematic training for minority recruitment. Many stakeholders acknowledged the benefits of minority recruitment training and welcomed training that focuses on increasing cultural awareness to increase the participation of minorities in cancer clinical trials.

  7. Digital image integration technique of multi-geoscience information dominated by aerial radiometric measurements

    International Nuclear Information System (INIS)

    Liu Dechang; Sun Maorong; Zhu Deling; Zhang Jingbo; He Jianguo; Dong Xiuzhen

    1992-02-01

    The geologic metallogenetic environment of uranium at Lian Shan Guan region has been studied by using digital image integration technique of multi-geoscience information with aerial radiometric measurements. It includes the classification of uranium-bearing rock, recognizing patterns of ore-forming and geologic mapping in ore field. Some new tectonic structure was found in this region that gives significant information for further exploring of uranium ore. After multi-parameters screening of aerial radiometric data, patterns recognizing and multi-geoscience information integration analysis, four prospective metallogenetic zones were predicted, and the predication was proved by further geologic survey. Three of the four zones are very encouraging, where ore-forming structures, hydrothermal deposits, wall-rock alteration, primary and secondary uranium ore and rich uranium mineralization are discovered. The department of geologic exploring has decided that these zones will enjoy priority in the examination for further prospecting of uranium ores

  8. The formation of professional identity in medical students: considerations for educators.

    Science.gov (United States)

    Goldie, John

    2012-01-01

    Medical education is about more than acquiring an appropriate level of knowledge and developing relevant skills. To practice medicine students need to develop a professional identity--ways of being and relating in professional contexts. This article conceptualises the processes underlying the formation and maintenance of medical students' professional identity drawing on concepts from social psychology. A multi-dimensional model of identity and identity formation, along with the concepts of identity capital and multiple identities, are presented. The implications for educators are discussed. Identity formation is mainly social and relational in nature. Educators, and the wider medical society, need to utilise and maximise the opportunities that exist in the various relational settings students experience. Education in its broadest sense is about the transformation of the self into new ways of thinking and relating. Helping students form, and successfully integrate their professional selves into their multiple identities, is a fundamental of medical education.

  9. Multidisciplinary management--an opportunity for service integration.

    Science.gov (United States)

    Cameron, M

    1997-01-01

    The management team of the future will enter an environment requiring facilitation, participation, clinical, and empowerment skills. Those individuals who possess a clinical orientation as well as business expertise will be sought to manage multidisciplinary units. The rapid changes in the health-care environment have forced organizations to restructure their operations. To achieve quality care, customer satisfaction, cost-effectiveness, and efficiency, service integration across the organization will be required. As we approach the 21st century, this standard will evolve until "all levels are managing patient care." Some of the restructuring trends occurring in the health-care industry have been collaboration service integration, management consolidation, and job elimination. The emphasis for the multidisciplinary manager of the future will include integrating the professional and clinical services, managing information, building community partnerships, promoting physician collaboration, and managing the change process. A model organization in the next century will move toward a people-oriented system with inclusion and empowerment initiatives. Service integration will affect all organizations, but the disciplines within the Clinical Support System will be the most affected. Future opportunities of leadership will exist for pathologists, nurses, or medical technologists as the professional silos of managers and clinicians continue to crumble.

  10. Negotiation skills for clinical research professionals

    Directory of Open Access Journals (Sweden)

    Sanjay Hake

    2011-01-01

    Full Text Available Negotiation as a skill is a key requirement for each and every job profile where dealing with multiple parties is involved. The important focus while negotiating should be on the interest then position. Key to every successful negotiation is advance planning, preparation, and patience as the objective is to create value and establish the terms on which parties with differing and often conflicting aims will co-operate. While preparing one should collect facts, know priorities, principles, identify common ground, decide on walk-away position, and try and identify the next best alternative. Negotiation is a set of skills that can be learned and practiced so that your ability to utilize relationship, knowledge, money, power, time, and personality to negotiate improves with each negotiation. In a successful negotiation, all parties win. Important thing to note is that not every negotiation involves money. Anytime you want something from someone else and anytime someone wants something from you, you are negotiating. Everything is negotiable and every day you negotiate with customers, suppliers, colleagues, your wife, and even your children. Negotiation is a game, and like any game it has its rules and tactics. Clinical Research professionals deal with various parties for different purposes at the same time; hence, they require excellent negotiation skills. Project Mangers and Clinical Research Associates are the two most important roles in clinical research industry who require negotiation skills as they deal with various internal and external customers and vendors.

  11. Negotiation skills for clinical research professionals

    Science.gov (United States)

    Hake, Sanjay; Shah, Tapankumar

    2011-01-01

    Negotiation as a skill is a key requirement for each and every job profile where dealing with multiple parties is involved. The important focus while negotiating should be on the interest then position. Key to every successful negotiation is advance planning, preparation, and patience as the objective is to create value and establish the terms on which parties with differing and often conflicting aims will co-operate. While preparing one should collect facts, know priorities, principles, identify common ground, decide on walk-away position, and try and identify the next best alternative. Negotiation is a set of skills that can be learned and practiced so that your ability to utilize relationship, knowledge, money, power, time, and personality to negotiate improves with each negotiation. In a successful negotiation, all parties win. Important thing to note is that not every negotiation involves money. Anytime you want something from someone else and anytime someone wants something from you, you are negotiating. Everything is negotiable and every day you negotiate with customers, suppliers, colleagues, your wife, and even your children. Negotiation is a game, and like any game it has its rules and tactics. Clinical Research professionals deal with various parties for different purposes at the same time; hence, they require excellent negotiation skills. Project Mangers and Clinical Research Associates are the two most important roles in clinical research industry who require negotiation skills as they deal with various internal and external customers and vendors. PMID:21897886

  12. Design and performance of a multi-channel, multi-sampling, PSD-enabling integrated circuit

    Energy Technology Data Exchange (ETDEWEB)

    Engel, G.L., E-mail: gengel@siue.ed [Department of Electrical and Computer Engineering, VLSI Design Research Laboratory, Southern Illinois University Edwardsville, Engineering Building, Room 3043 Edwardsville, IL 62026 1081 (United States); Hall, M.J.; Proctor, J.M. [Department of Electrical and Computer Engineering, VLSI Design Research Laboratory, Southern Illinois University Edwardsville, Engineering Building, Room 3043 Edwardsville, IL 62026 1081 (United States); Elson, J.M.; Sobotka, L.G.; Shane, R.; Charity, R.J. [Departments of Chemistry and Physics, Washington University, Saint Louis, MO 63130 (United States)

    2009-12-21

    This paper presents the design and test results of an eight-channel prototype integrated circuit chip intended to greatly simplify the pulse-processing electronics needed for large arrays of scintillation detectors. Because the chip design employs (user-controlled) multi-region charge integration, particle identification is incorporated into the basic design. Each channel on the chip also contains a time-to-voltage converter which provides relative time information. The pulse-height integrals and the relative time are all stored on capacitors and are either reset, after a user controlled time, or sequentially read out if acquisition of the event is desired. Each of the three pulse-height sub-channels consists of a gated integrator with eight programmable charging rates and an externally programmable gate generator that defines the start (with four time ranges) and width (with four time ranges) of the gate relative to an external discriminator signal. The chip supports three triggering modes, two time ranges, two power modes, and produces four sparsified analog pulse trains (three for the integrators and another for the time) with synchronized addresses for off-chip digitization with a pipelined ADC. The eight-channel prototype chip occupies an area of 2.8 mmx5.7 mm, dissipates 60 mW (low-power mode), and was fabricated in the AMI 0.5-mum process (C5N).

  13. Design and performance of a multi-channel, multi-sampling, PSD-enabling integrated circuit

    International Nuclear Information System (INIS)

    Engel, G.L.; Hall, M.J.; Proctor, J.M.; Elson, J.M.; Sobotka, L.G.; Shane, R.; Charity, R.J.

    2009-01-01

    This paper presents the design and test results of an eight-channel prototype integrated circuit chip intended to greatly simplify the pulse-processing electronics needed for large arrays of scintillation detectors. Because the chip design employs (user-controlled) multi-region charge integration, particle identification is incorporated into the basic design. Each channel on the chip also contains a time-to-voltage converter which provides relative time information. The pulse-height integrals and the relative time are all stored on capacitors and are either reset, after a user controlled time, or sequentially read out if acquisition of the event is desired. Each of the three pulse-height sub-channels consists of a gated integrator with eight programmable charging rates and an externally programmable gate generator that defines the start (with four time ranges) and width (with four time ranges) of the gate relative to an external discriminator signal. The chip supports three triggering modes, two time ranges, two power modes, and produces four sparsified analog pulse trains (three for the integrators and another for the time) with synchronized addresses for off-chip digitization with a pipelined ADC. The eight-channel prototype chip occupies an area of 2.8 mmx5.7 mm, dissipates 60 mW (low-power mode), and was fabricated in the AMI 0.5-μm process (C5N).

  14. Bridging Professional Teacher Knowledge for Science and Literary Integration via Design-Based Research

    Science.gov (United States)

    Fazio, Xavier; Gallagher, Tiffany L.

    2018-01-01

    We offer insights for using design-based research (DBR) as a model for constructing professional development that supports curriculum and instructional knowledge regarding science and literacy integration. We spotlight experiences in the DBR process from data collected from a sample of four elementary teachers. Findings from interviews, focus…

  15. University Outdoor Activities: an integral approach in the professional formation

    Directory of Open Access Journals (Sweden)

    María Ofelia Armas-Álvarez

    2012-09-01

    Full Text Available The work is lead to establish the theoretical foundations of the university outdoor labour from the organizational forms of the teaching process that favour the knowledge acquisition and the development of necessary skills in the students to promote culture in the different moments where they have connection with the society by means of the participation of the subjects and disciplines of the current programs that allow to organize systematic and articulated activities, appropriately planned, able to satisfy the necessities and to achieve the purpose of getting the preparation and integral cultural formation, as well as the their appropriate projection in the social environment that demands the contemporary society from the university professionals. In the work they are determined the content and skills that the student requires to promote Physical Culture in correspondence with their professional performance. It is designed a plan of activities to carry out the university outdoor labour from the organizational forms of the teaching process.

  16. Optimal unit sizing for small-scale integrated energy systems using multi-objective interval optimization and evidential reasoning approach

    International Nuclear Information System (INIS)

    Wei, F.; Wu, Q.H.; Jing, Z.X.; Chen, J.J.; Zhou, X.X.

    2016-01-01

    This paper proposes a comprehensive framework including a multi-objective interval optimization model and evidential reasoning (ER) approach to solve the unit sizing problem of small-scale integrated energy systems, with uncertain wind and solar energies integrated. In the multi-objective interval optimization model, interval variables are introduced to tackle the uncertainties of the optimization problem. Aiming at simultaneously considering the cost and risk of a business investment, the average and deviation of life cycle cost (LCC) of the integrated energy system are formulated. In order to solve the problem, a novel multi-objective optimization algorithm, MGSOACC (multi-objective group search optimizer with adaptive covariance matrix and chaotic search), is developed, employing adaptive covariance matrix to make the search strategy adaptive and applying chaotic search to maintain the diversity of group. Furthermore, ER approach is applied to deal with multiple interests of an investor at the business decision making stage and to determine the final unit sizing solution from the Pareto-optimal solutions. This paper reports on the simulation results obtained using a small-scale direct district heating system (DH) and a small-scale district heating and cooling system (DHC) optimized by the proposed framework. The results demonstrate the superiority of the multi-objective interval optimization model and ER approach in tackling the unit sizing problem of integrated energy systems considering the integration of uncertian wind and solar energies. - Highlights: • Cost and risk of investment in small-scale integrated energy systems are considered. • A multi-objective interval optimization model is presented. • A novel multi-objective optimization algorithm (MGSOACC) is proposed. • The evidential reasoning (ER) approach is used to obtain the final optimal solution. • The MGSOACC and ER can tackle the unit sizing problem efficiently.

  17. MONGKIE: an integrated tool for network analysis and visualization for multi-omics data.

    Science.gov (United States)

    Jang, Yeongjun; Yu, Namhee; Seo, Jihae; Kim, Sun; Lee, Sanghyuk

    2016-03-18

    Network-based integrative analysis is a powerful technique for extracting biological insights from multilayered omics data such as somatic mutations, copy number variations, and gene expression data. However, integrated analysis of multi-omics data is quite complicated and can hardly be done in an automated way. Thus, a powerful interactive visual mining tool supporting diverse analysis algorithms for identification of driver genes and regulatory modules is much needed. Here, we present a software platform that integrates network visualization with omics data analysis tools seamlessly. The visualization unit supports various options for displaying multi-omics data as well as unique network models for describing sophisticated biological networks such as complex biomolecular reactions. In addition, we implemented diverse in-house algorithms for network analysis including network clustering and over-representation analysis. Novel functions include facile definition and optimized visualization of subgroups, comparison of a series of data sets in an identical network by data-to-visual mapping and subsequent overlaying function, and management of custom interaction networks. Utility of MONGKIE for network-based visual data mining of multi-omics data was demonstrated by analysis of the TCGA glioblastoma data. MONGKIE was developed in Java based on the NetBeans plugin architecture, thus being OS-independent with intrinsic support of module extension by third-party developers. We believe that MONGKIE would be a valuable addition to network analysis software by supporting many unique features and visualization options, especially for analysing multi-omics data sets in cancer and other diseases. .

  18. Interorganisational Integration

    DEFF Research Database (Denmark)

    Lyngsø, Anne Marie; Godtfredsen, Nina Skavlan; Frølich, Anne

    2016-01-01

    INTRODUCTION: Despite many initiatives to improve coordination of patient pathways and intersectoral cooperation, Danish health care is still fragmented, lacking intra- and interorganisational integration. This study explores barriers to and facilitators of interorganisational integration...... at a university hospital in the Capital Region of Denmark. RESULTS AND DISCUSSION: Our results can be grouped into five influencing areas for interorganisational integration: communication/information transfer, committed leadership, patient engagement, the role and competencies of the general practitioner...... and organisational culture. Proposed solutions to barriers in each area hold the potential to improve care integration as experienced by individuals responsible for supporting and facilitating it. Barriers and facilitators to integrating care relate to clinical, professional, functional and normative integration...

  19. Clinical simulation practise framework.

    Science.gov (United States)

    Khalili, Hossein

    2015-02-01

    Historically, simulation has mainly been used to teach students hands-on skills in a relatively safe environment. With changes in the patient population, professional regulations and clinical environments, clinical simulation practise (CSP) must assist students to integrate and apply their theoretical knowledge and skills with their critical thinking, clinical judgement, prioritisation, problem solving, decision making, and teamwork skills to provide holistic care and treatment to their patients. CSP holds great potential to derive a positive transformation in students' transition into the workplace, by associating and consolidating learning from classrooms to clinical settings, and creating bridges between theory and practice. For CSP to be successful in filling the gap, the design and management of the simulation is crucial. In this article a new framework called 'Clinical simulation practise framework: A knowledge to action strategy in health professional education' is being introduced that aims to assist educators and curriculum developers in designing and managing their simulations. This CSP framework theorises that simulation as an experiential educational tool could improve students' competence, confidence and collaboration in performing professional practice in real settings if the CSP provides the following three dimensions: (1) a safe, positive, reflective and fun simulated learning environment; (2) challenging, but realistic, and integrated simulated scenarios; and (3) interactive, inclusive, interprofessional patient-centred simulated practise. © 2015 John Wiley & Sons Ltd.

  20. Integrated Process Design and Control of Multi-element Reactive Distillation Processes

    DEFF Research Database (Denmark)

    Mansouri, Seyed Soheil; Sales-Cruz, Mauricio; Huusom, Jakob Kjøbsted

    2016-01-01

    In this work, integrated process design and control of reactive distillation processes involving multi-elements is presented. The reactive distillation column is designed using methods and tools which are similar in concept to non-reactive distillation design methods, such as driving force approach....... The methods employed in this work are based on equivalent element concept. This concept facilitates the representation of a multi-element reactive system as equivalent binary light and heavy key elements. First, the reactive distillation column is designed at the maximum driving force where through steady...

  1. Multi-Objective Optimization in Physical Synthesis of Integrated Circuits

    CERN Document Server

    A Papa, David

    2013-01-01

    This book introduces techniques that advance the capabilities and strength of modern software tools for physical synthesis, with the ultimate goal to improve the quality of leading-edge semiconductor products.  It provides a comprehensive introduction to physical synthesis and takes the reader methodically from first principles through state-of-the-art optimizations used in cutting edge industrial tools. It explains how to integrate chip optimizations in novel ways to create powerful circuit transformations that help satisfy performance requirements. Broadens the scope of physical synthesis optimization to include accurate transformations operating between the global and local scales; Integrates groups of related transformations to break circular dependencies and increase the number of circuit elements that can be jointly optimized to escape local minima;  Derives several multi-objective optimizations from first observations through complete algorithms and experiments; Describes integrated optimization te...

  2. Transforming differential equations of multi-loop Feynman integrals into canonical form

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, Christoph [Institut für Physik, Humboldt-Universität zu Berlin,12489 Berlin (Germany)

    2017-04-03

    The method of differential equations has been proven to be a powerful tool for the computation of multi-loop Feynman integrals appearing in quantum field theory. It has been observed that in many instances a canonical basis can be chosen, which drastically simplifies the solution of the differential equation. In this paper, an algorithm is presented that computes the transformation to a canonical basis, starting from some basis that is, for instance, obtained by the usual integration-by-parts reduction techniques. The algorithm requires the existence of a rational transformation to a canonical basis, but is otherwise completely agnostic about the differential equation. In particular, it is applicable to problems involving multiple scales and allows for a rational dependence on the dimensional regulator. It is demonstrated that the algorithm is suitable for current multi-loop calculations by presenting its successful application to a number of non-trivial examples.

  3. Transforming differential equations of multi-loop Feynman integrals into canonical form

    Science.gov (United States)

    Meyer, Christoph

    2017-04-01

    The method of differential equations has been proven to be a powerful tool for the computation of multi-loop Feynman integrals appearing in quantum field theory. It has been observed that in many instances a canonical basis can be chosen, which drastically simplifies the solution of the differential equation. In this paper, an algorithm is presented that computes the transformation to a canonical basis, starting from some basis that is, for instance, obtained by the usual integration-by-parts reduction techniques. The algorithm requires the existence of a rational transformation to a canonical basis, but is otherwise completely agnostic about the differential equation. In particular, it is applicable to problems involving multiple scales and allows for a rational dependence on the dimensional regulator. It is demonstrated that the algorithm is suitable for current multi-loop calculations by presenting its successful application to a number of non-trivial examples.

  4. Transforming differential equations of multi-loop Feynman integrals into canonical form

    International Nuclear Information System (INIS)

    Meyer, Christoph

    2017-01-01

    The method of differential equations has been proven to be a powerful tool for the computation of multi-loop Feynman integrals appearing in quantum field theory. It has been observed that in many instances a canonical basis can be chosen, which drastically simplifies the solution of the differential equation. In this paper, an algorithm is presented that computes the transformation to a canonical basis, starting from some basis that is, for instance, obtained by the usual integration-by-parts reduction techniques. The algorithm requires the existence of a rational transformation to a canonical basis, but is otherwise completely agnostic about the differential equation. In particular, it is applicable to problems involving multiple scales and allows for a rational dependence on the dimensional regulator. It is demonstrated that the algorithm is suitable for current multi-loop calculations by presenting its successful application to a number of non-trivial examples.

  5. What Are the Ethical Issues Facing Global-Health Trainees Working Overseas? A Multi-Professional Qualitative Study

    Directory of Open Access Journals (Sweden)

    James D. Harrison

    2016-07-01

    Full Text Available The aim of this study was to identify global health ethical issues that health professional trainees may encounter during electives or placements in resource-limited countries. We conducted a qualitative study involving focus groups and an interview at the University of California San Francisco. Participants were multi-professional from the Schools of Medicine, Nursing and Pharmacy and had experience working, or teaching, as providers in resource-limited countries. Eighteen participants provided examples of ethical dilemmas associated with global-health outreach work. Ethical dilemmas fell into four major themes relating to (1 cultural differences (informed consent, truth-telling, autonomy; (2 professional issues (power dynamics, training of local staff, corruption; (3 limited resources (scope of practice, material shortages; (4 personal moral development (dealing with moral distress, establishing a moral compass, humility and self awareness. Three themes (cultural differences, professional issues, limited resources were grouped under the core category of “external environmental and/or situational issues” that trainees are confronted when overseas. The fourth theme, moral development, refers to the development of a moral compass and the exercise of humility and self-awareness. The study has identified case vignettes that can be used for curriculum content for global-health ethics training.

  6. What Are the Ethical Issues Facing Global-Health Trainees Working Overseas? A Multi-Professional Qualitative Study

    Science.gov (United States)

    Harrison, James D.; Logar, Tea; Le, Phuoc; Glass, Marcia

    2016-01-01

    The aim of this study was to identify global health ethical issues that health professional trainees may encounter during electives or placements in resource-limited countries. We conducted a qualitative study involving focus groups and an interview at the University of California San Francisco. Participants were multi-professional from the Schools of Medicine, Nursing and Pharmacy and had experience working, or teaching, as providers in resource-limited countries. Eighteen participants provided examples of ethical dilemmas associated with global-health outreach work. Ethical dilemmas fell into four major themes relating to (1) cultural differences (informed consent, truth-telling, autonomy); (2) professional issues (power dynamics, training of local staff, corruption); (3) limited resources (scope of practice, material shortages); (4) personal moral development (dealing with moral distress, establishing a moral compass, humility and self awareness). Three themes (cultural differences, professional issues, limited resources) were grouped under the core category of “external environmental and/or situational issues” that trainees are confronted when overseas. The fourth theme, moral development, refers to the development of a moral compass and the exercise of humility and self-awareness. The study has identified case vignettes that can be used for curriculum content for global-health ethics training. PMID:27417631

  7. Effective use of technology in clinical supervision

    Directory of Open Access Journals (Sweden)

    Priya Martin

    2017-06-01

    Full Text Available Clinical supervision is integral to continuing professional development of health professionals. With advances in technology, clinical supervision too can be undertaken using mediums such as videoconference, email and teleconference. This mode of clinical supervision is termed as telesupervision. While telesupervision could be useful in any context, its value is amplified for health professionals working in rural and remote areas where access to supervisors within the local work environment is often diminished. While telesupervision offers innovative means to undertake clinical supervision, there remain gaps in the literature in terms of its parameters of use in clinical practice. This article outlines ten evidence-informed, practical tips stemming from a review of the literature that will enable health care stakeholders to use technology effectively and efficiently while undertaking clinical supervision. By highlighting the “how to” aspect, telesupervision can be delivered in the right way, to the right health professional, at the right time.

  8. Professional autonomy in 21st century healthcare: Nurses' accounts of clinical decision-making

    DEFF Research Database (Denmark)

    Traynor, Michael; Boland, Maggie; Buus, Niels

    2010-01-01

    Autonomy in decision-making has traditionally been described as a feature of professional work, however the work of healthcare professionals has been seen as steadily encroached upon by State and managerialist forces. Nursing has faced particular problems in establishing itself as a credible....... The study uses accounts of decision-making to gain insight into contemporary professional nursing. The study also aims to explore the usefulness of a theory of professional work set out by Jamous and Peloille (1970). The analysis draws on notions of interpretive repertoires and elements of narrative...... analysis. We identified two interpretive repertoires: 'clinical judgement' which was used to describe the different grounds for making judgements; and 'decision-making' which was used to describe organisational circumstances influencing decision-making. Jamous and Peloille's theory proved useful...

  9. A fully Bayesian latent variable model for integrative clustering analysis of multi-type omics data.

    Science.gov (United States)

    Mo, Qianxing; Shen, Ronglai; Guo, Cui; Vannucci, Marina; Chan, Keith S; Hilsenbeck, Susan G

    2018-01-01

    Identification of clinically relevant tumor subtypes and omics signatures is an important task in cancer translational research for precision medicine. Large-scale genomic profiling studies such as The Cancer Genome Atlas (TCGA) Research Network have generated vast amounts of genomic, transcriptomic, epigenomic, and proteomic data. While these studies have provided great resources for researchers to discover clinically relevant tumor subtypes and driver molecular alterations, there are few computationally efficient methods and tools for integrative clustering analysis of these multi-type omics data. Therefore, the aim of this article is to develop a fully Bayesian latent variable method (called iClusterBayes) that can jointly model omics data of continuous and discrete data types for identification of tumor subtypes and relevant omics features. Specifically, the proposed method uses a few latent variables to capture the inherent structure of multiple omics data sets to achieve joint dimension reduction. As a result, the tumor samples can be clustered in the latent variable space and relevant omics features that drive the sample clustering are identified through Bayesian variable selection. This method significantly improve on the existing integrative clustering method iClusterPlus in terms of statistical inference and computational speed. By analyzing TCGA and simulated data sets, we demonstrate the excellent performance of the proposed method in revealing clinically meaningful tumor subtypes and driver omics features. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. A multi-faceted tailored strategy to implement an electronic clinical decision support system for pressure ulcer prevention in nursing homes: a two-armed randomized controlled trial.

    Science.gov (United States)

    Beeckman, Dimitri; Clays, Els; Van Hecke, Ann; Vanderwee, Katrien; Schoonhoven, Lisette; Verhaeghe, Sofie

    2013-04-01

    Frail older people admitted to nursing homes are at risk of a range of adverse outcomes, including pressure ulcers. Clinical decision support systems are believed to have the potential to improve care and to change the behaviour of healthcare professionals. To determine whether a multi-faceted tailored strategy to implement an electronic clinical decision support system for pressure ulcer prevention improves adherence to recommendations for pressure ulcer prevention in nursing homes. Two-armed randomized controlled trial in a nursing home setting in Belgium. The trial consisted of a 16-week implementation intervention between February and June 2010, including one baseline, four intermediate, and one post-testing measurement. Primary outcome was the adherence to guideline-based care recommendations (in terms of allocating adequate pressure ulcer prevention in residents at risk). Secondary outcomes were the change in resident outcomes (pressure ulcer prevalence) and intermediate outcomes (knowledge and attitudes of healthcare professionals). Random sample of 11 wards (6 experimental; 5 control) in a convenience sample of 4 nursing homes in Belgium. In total, 464 nursing home residents and 118 healthcare professionals participated. The experimental arm was involved in a multi-faceted tailored implementation intervention of a clinical decision support system, including interactive education, reminders, monitoring, feedback and leadership. The control arm received a hard-copy of the pressure ulcer prevention protocol, supported by standardized 30 min group lecture. Patients in the intervention arm were significantly more likely to receive fully adequate pressure ulcer prevention when seated in a chair (F=16.4, P=0.003). No significant improvement was observed on pressure ulcer prevalence and knowledge of the professionals. While baseline attitude scores were comparable between both groups [exp. 74.3% vs. contr. 74.5% (P=0.92)], the mean score after the intervention was

  11. AN INTEGRATED PERFORMANCE MANAGEMENT FRAMEWORK FOR A MULTI-BUSINESS COMPANY

    Directory of Open Access Journals (Sweden)

    H.M. Aburas

    2012-01-01

    Full Text Available

    ENGLISH ABSTRACT: A multi-business company is a complex entity. Evaluating corporate performance of such an organisation is even more challenging. Corporate performance is inherently multidimensional in nature, is viewed from various perspectives, and has to satisfy multiple objectives. It is multi-dimensional in the sense of being a function of many variables that drive firm performance; multi-perspectival, from various stakeholders’ standpoints; and multi-objectives are to be optimised. So there is no single corporate performance evaluation tool that can be prescribed as a stand-alone gauge; however, a unified and holistic corporate performance management system can be developed from multiple tools. This paper attempts to bring together a variety of performance management tools that have evolved and developed in theory, and have been tested and applied in practice. In developing this convergence, first a set of criteria that answers the multi-dimensional, multi-perspectival, and multi-objective requirements of a firm’s performance will be identified and weighted. Second, management tools that have been used either singly or in combination by multi-business companies are reviewed and ranked against the chosen criteria. Finally, an integrated model or framework that brings together and unifies the elements of these ranked performance management tools is proposed.

    AFRIKAANSE OPSOMMING: D‘n Multi-maatskappy-onderneming is ‘n komplekse entiteit. Die evaluasie van maatskappyprestasie van so ‘n onderneming is self meer van ‘n uitdaging. Maatskappyprestasie is inherent multidimensioneel, word uit verskeie perspektiewe beskou en moet veelvuldige doelwitte bevredig. Geen enkele maatstaf is beskikbaar om hierdie fasette van maatskappyprestasie te evalueer, alhoewel ‘n holistiese prestasiebestuurstelsel ontwikkel kan word gebaseer op verskillende maatstawwe. Hierdie artikel bring verskillende metodologieë byeen vir die meting van

  12. Study on integrated TRU multi-recycling in sodium cooled fast reactor CDFR

    International Nuclear Information System (INIS)

    Hu Yun; Xu Mi; Wang Kan

    2010-01-01

    In view of recently proposed closed fuel cycle strategy which would recycle the integrated transuranics (TRU) from PWR spent fuel in the fast reactors, the neutronics characteristics of TRU recycled in China Demonstration Fast Reactor (CDFR) are studied in this paper. The results show that loading integrated TRU to substitute pure Pu as driver fuel will mainly make the influence on sodium void worth and negligible effects on other parameters, and hence TRU recycling in CDFR is feasible from viewpoint of core neutronics. If TRU is multi-recycled, the variation of TRU composition depends on fuel types and the ratio of TRU and U when recycling. It is indicated that, when TRU is multi-recycled in CDFR with MOX fuel, the minor actinides (MA) fraction in TRU will firstly decrease to ∼7.24% (minimum) within 8 TRU recycle times and then slowly increase to ∼7.7% after 20 TRU recycle times; while when TRU is multi-recycled in CDFR with metal fuel (TRU-U-10Zr), the MA fraction in TRU will gradually approach to an equilibrium state with the MA fraction of ∼3.8%, demonstrating better MA transmutation effect in metal fuel core. No matter 7.7 or 3.8%, they are both lower than ∼10% in PWR spent fuel with burnup of 45 GWd/tU, which presents satisfying effect of MA amount controlling for TRU multi-recycling strategy. On the other hand, the corresponding recycling parameters such as TRU heat release and neutron emission rate are also much lower in metal fuel than those in MOX fuel. Moreover, TRU recycled in metal fuel will bring greater fissile Pu isotopes equilibrium fraction due to better breeding capability of metal fuel. Finally, it could be summarized that integrated TRU multi-recycling in fast reactor can make contributions to both breeding and transmutation, and such strategy is a prospective closed fuel cycle manner to achieve the object of effective control of cumulated MA amount and sustainable development of nuclear energy.

  13. Arts Integration as Potentiality for Professional Development for School Teachers

    DEFF Research Database (Denmark)

    Jensen, Julie Borup

    This paper investigates the potentialities for professional development, when teachers work with integration of arts and academic subjects in the classroom. The idea of integrating arts and academic subjects can be seen as a way of experimenting with teaching. Experiments in the classroom as a way...... of creating new knowledge about teaching is very closely linked to ideas from action research approaches to development of both new practices and new knowledge. Therefore, we will draw on concepts from action research theory to explore how teachers learn and at the same time develop new knowledge when......: Experience, Exploration, and Experimentation. In this way, the action research approach has the possibility of creating not only new practices, but also to develop new theoretic understanding of the learning processes involved in creating change in a living practice as classroom teaching. As an empirical...

  14. IMPERA: Integrated Mission Planning for Multi-Robot Systems

    Directory of Open Access Journals (Sweden)

    Daniel Saur

    2015-10-01

    Full Text Available This paper presents the results of the project IMPERA (Integrated Mission Planning for Distributed Robot Systems. The goal of IMPERA was to realize an extraterrestrial exploration scenario using a heterogeneous multi-robot system. The main challenge was the development of a multi-robot planning and plan execution architecture. The robot team consists of three heterogeneous robots, which have to explore an unknown environment and collect lunar drill samples. The team activities are described using the language ALICA (A Language for Interactive Agents. Furthermore, we use the mission planning system pRoPhEt MAS (Reactive Planning Engine for Multi-Agent Systems to provide an intuitive interface to generate team activities. Therefore, we define the basic skills of our team with ALICA and define the desired goal states by using a logic description. Based on the skills, pRoPhEt MAS creates a valid ALICA plan, which will be executed by the team. The paper describes the basic components for communication, coordinated exploration, perception and object transportation. Finally, we evaluate the planning engine pRoPhEt MAS in the IMPERA scenario. In addition, we present further evaluation of pRoPhEt MAS in more dynamic environments.

  15. Participatory Planning, Monitoring and Evaluation of Multi-Stakeholder Platforms in Integrated Landscape Initiatives.

    Science.gov (United States)

    Kusters, Koen; Buck, Louise; de Graaf, Maartje; Minang, Peter; van Oosten, Cora; Zagt, Roderick

    2017-03-21

    Integrated landscape initiatives typically aim to strengthen landscape governance by developing and facilitating multi-stakeholder platforms. These are institutional coordination mechanisms that enable discussions, negotiations, and joint planning between stakeholders from various sectors in a given landscape. Multi-stakeholder platforms tend to involve complex processes with diverse actors, whose objectives and focus may be subjected to periodic re-evaluation, revision or reform. In this article we propose a participatory method to aid planning, monitoring, and evaluation of such platforms, and we report on experiences from piloting the method in Ghana and Indonesia. The method is comprised of three components. The first can be used to look ahead, identifying priorities for future multi-stakeholder collaboration in the landscape. It is based on the identification of four aspirations that are common across multi-stakeholder platforms in integrated landscape initiatives. The second can be used to look inward. It focuses on the processes within an existing multi-stakeholder platform in order to identify areas for possible improvement. The third can be used to look back, identifying the main outcomes of an existing platform and comparing them to the original objectives. The three components can be implemented together or separately. They can be used to inform planning and adaptive management of the platform, as well as to demonstrate performance and inform the design of new interventions.

  16. Building a Multi-centre Clinical Research Facilitation Network: The ARC Experience

    Directory of Open Access Journals (Sweden)

    Ian Nicholson

    2017-06-01

    Full Text Available Introduction: In order to practice evidence-based veterinary medicine, good quality clinical evidence needs to be produced, in order that it can be apprasied systematically by the EBVM network, and used by vets. There is very little good-quality veterinary evidence for most of the veterinary procedures carried out every day across the world. Very few, if any, individuals have all the necessary qualities (case-load, time, research expertise, financial support to be able to systematically produce good-quality, and relevant, clinical research on their own, in a timely manner. The Association for Veterinary Soft Tissue Surgery (AVSTS www.avsts.org.uk is an affiliate group with the British Small Animal Veterinary Association (BSAVA, and functions as a clinical network of like-minded individuals. In 2013 AVSTS sought to create a role for itself in facilitating the production (by its members of multi-centre clinical research of relevance to its members.Materials and methods: Members of AVSTS were asked to join the AVSTS Research Cooperative (ARC, with a veterinary epidemiologist and an experienced multi-centre veterinary clinical researcher (to help with study design and statistical planning, and the Animal Health Trust clinical research ethics committee. An email list was established, and a page was set up on the AVSTS website, to allow information to be disseminated. The AVSTS spring and autumn meetings were used as a regular forum by ARC, to discuss its direction, to generate interest, to create and promote specific studies (in order to widen participation amongst different centres, and to update members about previous studies.Results: Membership of ARC has grown to 224 people, although the epidemiologist left. One multi-centre study has been published, two have been presented and await publication, one has been accepted for presentation, two other studies are gathering data at present, and further studies are in the pipeline. There has been

  17. Integrable couplings of the multi-component Dirac hierarchy and its Hamiltonian structure

    International Nuclear Information System (INIS)

    Li Zhu; Dong Huanhe

    2008-01-01

    Integrable couplings of the multi-component Dirac hierarchy is obtained by use of the vector loop algebra G ∼ M , then the Hamiltonian structure of the above system is given by the quadratic-form identity

  18. Multi-Sensory Integration Impairment in Patients with Minimal Hepatic Encephalopathy.

    Science.gov (United States)

    Seo, Kyoungwon; Jun, Dae Won; Kim, Jae-Kwan; Ryu, Hokyoung

    2017-11-02

    Paper-and-pencil-based psychometric tests are the gold standard for diagnosis of cognitive dysfunction in liver disease. However, they take time, can be affected by demographic factors, and lack ecological validity. This study explored multi-sensory integration ability to discriminate cognitive dysfunction in cirrhosis. Thirty-two healthy controls and 30 cirrhotic patients were recruited. The sensory integration test presents stimuli from two different modalities (e.g., image/sound) with a short time lag, and subjects judge which stimuli appeared first. Repetitive tests reveal the sensory integration capability. Performance in the sensory integration test, psychometric tests, and functional near-infrared spectroscopy for patients was compared to controls. Sensory integration capability, the perceptual threshold to discriminate the time gap between an image and sound stimulus, was significantly impaired in cirrhotic patients with minimal hepatic encephalopathy (MHE) compared to controls (p integration test showed good correlation with psychometric tests (NCT-A, r = 0.383, p = 0.002; NCT-B, r = 0.450, p integration test was not affected. The sensory integration test, where a cut-off value for the perceptual threshold was 133.3ms, recognized MHE patients at 90% sensitivity and 86.5% specificity.

  19. Clinical leadership as an integral curriculum thread in pre-registration nursing programmes.

    Science.gov (United States)

    Brown, Angela; Dewing, Jan; Crookes, Patrick

    2016-03-01

    In recent years there has been a growth in leadership development frameworks in health for the existing workforce. There has also been a related abundance of leadership programmes developed specifically for qualified nurses. There is a groundswell of opinion that clinical leadership preparation needs to extend to preparatory programmes leading to registration as a nurse. To this end a doctoral research study has been completed that focused specifically on the identification and verification of the antecedents of clinical leadership (leadership and management) so they can shape the curriculum content and the best way to deliver the curriculum content as a curriculum thread. To conceptualise how the curriculum content, identified and verified empirically, can be structured within a curriculum thread and to contribute to the discussion on effective pedagogical approaches and educational strategies for learning and teaching of clinical leadership. A multi-method design was utilised in the research in Australia. Drawing on core principles in critical social theory, an integral curriculum thread is proposed for pre-registration nursing programmes that identifies the antecedents of clinical leadership; the core concepts, together with the continuum of enlightenment, empowerment, and emancipation. The curriculum content, the effective pedagogical approaches and the educational strategies are supported theoretically and we believe this offers a design template for action and a way of thinking about this important aspect of preparatory nursing education. Moreover, we hope to have created a process contributing to a heighten sense of awareness in the nursing student (and other key stakeholders) of the what, how and when of clinical leadership for a novice registered nurse. The next stage is to further test through research the proposed integral curriculum thread. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Health care professionals' experience, understanding and perception of need of advanced cancer patients with cachexia and their families: The benefits of a dedicated clinic.

    Science.gov (United States)

    Scott, David; Reid, Joanne; Hudson, Peter; Martin, Peter; Porter, Sam

    2016-12-30

    Cachexia is defined as the on-going loss of skeletal muscle mass that cannot be fully reversed by conventional nutritional support. It is found in up to 80% of patients with advanced cancer and has profound psycho-social consequences for patients and their families. Previous studies demonstrate that many healthcare professionals receive little formal education in cachexia management leading them to feel that they have limited understanding of the syndrome and cannot intervene effectively. This study aims to examine the value of a dedicated cachexia clinic and its influence on staff understanding and practice. An exploratory qualitative study was conducted. The study employed semi-structured interviews with a range of healthcare professionals responsible for designing and delivering cancer care in a large teaching hospital in Australia. This hospital had a dedicated cachexia clinic. In-depth interviews were conducted with 8 healthcare professionals and senior managers. Four themes were identified: formal and informal education; knowledge and understanding; truth telling in cachexia and palliative care; and, a multi-disciplinary approach. Findings show that improved knowledge and understanding across a staff body can lead to enhanced staff confidence and a willingness to address cancer cachexia and its consequences with patients and their families. Comparisons with similar previous research demonstrate the advantages of providing a structure for staff to gain knowledge about cachexia and how this can contribute to feelings of improved understanding and confidence necessary to respond to the challenge of cachexia.

  1. The behaviours of nurses that increase student accountability for learning in clinical practice: An integrative review.

    Science.gov (United States)

    Perry, Christina; Henderson, Amanda; Grealish, Laurie

    2018-06-01

    To identify nurses' behaviours that promote student accountability for learning in clinical practice. Health care services are experiencing significant strain in meeting clinical education requirements of increasing numbers of nursing students enrolled in undergraduate nursing programs. Internationally, the transition to university based education for nurses has seen the emergence of issues for busy clinicians trying to manage increasing workloads with responsibility for student learning. An understanding of what types of supervisor behaviours promote student accountability for learning, may support clinicians to more effectively manage their dual roles of clinical care and student support. An integrative approach was adopted for this review. A search of the Cumulative Index of Nursing and Allied Health Literature, Pubmed, Scopus and Embase was undertaken, limited to articles published between 2000 and March 2017. Whittemore and Knafls' (2005) framework for conducting integrative reviews was used to ensure a methodological and rigorous approach. Nine studies were considered. Behaviours emerged in relation to four themes including: belongingness associated with a genuine partnership; empowerment and increasing student self-efficacy; trust linked to increasing and staged independence; and balancing clinical and educational requirements. Behaviours of nurses significantly influence students' accountability for learning and accordingly, their ability to be adequately prepared for professional nursing practice. Understanding behaviours that impact on students' approach to clinical placement can guide nurses in their approach to facilitating student learning, in particular, behaviours that increase student responsibility and independence over the continuum of clinical education. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. Physicians' Professionally Responsible Power: A Core Concept of Clinical Ethics.

    Science.gov (United States)

    McCullough, Laurence B

    2016-02-01

    The gathering of power unto themselves by physicians, a process supported by evidence-based practice, clinical guidelines, licensure, organizational culture, and other social factors, makes the ethics of power--the legitimation of physicians' power--a core concept of clinical ethics. In the absence of legitimation, the physician's power over patients becomes problematic, even predatory. As has occurred in previous issues of the Journal, the papers in the 2016 clinical ethics issue bear on the professionally responsible deployment of power by physicians. This introduction explores themes of physicians' power in papers from an international group of authors who address autonomy and trust, the virtues of perinatal hospice, conjoined twins in ethics and law, addiction and autonomy in clinical research on addicting substances, euthanasia of patients with dementia in Belgium, and a pragmatic approach to clinical futility. © The Author 2015. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Longitudinal Effects of Technology Integration and Teacher Professional Development on Students' Mathematics Achievement

    Science.gov (United States)

    Bicer, Ali; Capraro, Robert M.

    2017-01-01

    MathForward is a program that provides teacher professional development and integrates the use of technology as a tool in the classroom. The present study examined students' mathematics growth from 2012 to 2013 and observed how students' mathematics scores changed after their school implemented the MathForward program. The sample consisted of two…

  4. Integration of least angle regression with empirical Bayes for multi-locus genome-wide association studies

    Science.gov (United States)

    Multi-locus genome-wide association studies has become the state-of-the-art procedure to identify quantitative trait loci (QTL) associated with traits simultaneously. However, implementation of multi-locus model is still difficult. In this study, we integrated least angle regression with empirical B...

  5. How do educators in one New Zealand undergraduate Bachelor of Oral Health course teach and nurture professionalism?

    Science.gov (United States)

    Smith, L; Adam, L; Moffat, S; Meldrum, A; Ahmadi, R

    2018-05-01

    Research on integrated dental hygiene and dental therapy courses is scarce; studies reporting on how staff in these combined scope courses teach professionalism are even more scarce. This study aimed to partially fill these research gaps. In 2016, online surveys were sent to 34 staff members who taught into the integrated Bachelor of Oral Health (BOH) course at the University of Otago's Faculty of Dentistry; 13 were returned. Two focus groups were conducted with six BOH educators. Aspects of professionalism were taught and nurtured in the formal curriculum, the clinic and the informal curriculum. In the formal curriculum, policies outlining the professional standards of behaviour expected of oral health practitioners and students in New Zealand and the Faculty were discussed. In the clinic, educators taught professionalism through modelling clinical skills, assessing students' performance and commenting on their reflective logbooks. In the informal curriculum, BOH teachers nurtured professionalism through discussions about standards of behaviour outside of the university. Role modelling was the most common method that participants reported they taught or nurtured professionalism in their students. Professionalism is a complex concept that is taught and nurtured in a number of ways over all aspects of the course. Oral Health educators need to maintain a high standard of professionalism when interacting with students and patients, as well as in public spaces, in order to model professionalism to their students. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Does clinical supervision of healthcare professionals improve effectiveness of care and patient experience? A systematic review.

    Science.gov (United States)

    Snowdon, David A; Leggat, Sandra G; Taylor, Nicholas F

    2017-11-28

    To ensure quality of care delivery clinical supervision has been implemented in health services. While clinical supervision of health professionals has been shown to improve patient safety, its effect on other dimensions of quality of care is unknown. The purpose of this systematic review is to determine whether clinical supervision of health professionals improves effectiveness of care and patient experience. Databases MEDLINE, PsychINFO, CINAHL, EMBASE and AMED were searched from earliest date available. Additional studies were identified by searching of reference lists and citation tracking. Two reviewers independently applied inclusion and exclusion criteria. The quality of each study was rated using the Medical Education Research Study Quality Instrument. Data were extracted on effectiveness of care (process of care and patient health outcomes) and patient experience. Seventeen studies across multiple health professions (medical (n = 4), nursing (n = 7), allied health (n = 2) and combination of nursing, medical and/or allied health (n = 4)) met the inclusion criteria. The clinical heterogeneity of the included studies precluded meta-analysis. Twelve of 14 studies investigating 38,483 episodes of care found that clinical supervision improved the process of care. This effect was most predominant in cardiopulmonary resuscitation and African health settings. Three of six studies investigating 1756 patients found that clinical supervision improved patient health outcomes, namely neurological recovery post cardiopulmonary resuscitation (n = 1) and psychological symptom severity (n = 2). None of three studies investigating 1856 patients found that clinical supervision had an effect on patient experience. Clinical supervision of health professionals is associated with effectiveness of care. The review found significant improvement in the process of care that may improve compliance with processes that are associated with enhanced patient health

  7. Supporting students in professional socialisation: Guidelines for professional nurses and educators

    OpenAIRE

    Hester Cathrina (Rina) de Swardt; Gisela H. van Rensburg; M.J. Oosthuizen

    2017-01-01

    Professional socialisation of nursing students involves learning skills, attitudes, behaviour and professional roles, largely in the clinical area. During clinical accompaniment and reflective discussions with a group of undergraduate Baccalaureate nursing students in South Africa, students reported negative professional socialisation experiences, primarily in the clinical area. Such experiences could influence the quality of patient care. The objective of this study was to develop and valida...

  8. Clinical imprinting: the impact of early clinical learning on career long professional development in nursing.

    Science.gov (United States)

    Andrew, Nicola

    2013-05-01

    The literature recognises a relationship between clinical experience and a successful undergraduate experience in nursing; however what constitutes an effective approach remains the subject of debate, particularly in relation to first year of learning. There is evidence from a biological standpoint that early experience impacts on the behavioural development of animals, described by Konrad Lorenz (1903-1989) as 'imprinting'. The concept of imprinting has resonance for nursing. In this article the importance of 'getting it right at the beginning' is explored and what, if anything, Lorenz's theory tells us about the impact of early clinical learning on subsequent professional development. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Evaluation of services of the integrative health clinic in Hong Kong.

    Science.gov (United States)

    Chung, Joanne W Y; Chung, Louisa M Y; Kwok, Nedra W L; Wong, Thomas K S

    2008-10-01

    (i) To provide a profile of the clients who have used the Integrative Health Clinic's services, (ii) to determine the clients' extent of satisfaction with the services received and (iii) to assess whether integrative therapies can/should be recommended to other clinics. Based on the integration of various health paradigms and the use of health promotion strategies, our Integrative Health Clinic in Hong Kong provides a range of different therapies for integrated symptom management. The integrative therapies are derived from conventional, complementary and alternative medicine. Design. Postal survey, followed by routine data analysis. Hong Kong Chinese clients attending a residential community health clinic were surveyed about health status and satisfaction towards the services received. A total of 489 clients (30.8% were male and 69.2% female) were registered with the clinic during the study period. The mean age (SD) was 47.8 (15.4) years. The customer satisfaction survey found that traditional Chinese medicine consultation was the most frequently used modality of the Integrative Health Clinic, followed by pain management. Out of the 489 clients, those who attended the Integrative Health Clinic only once in the study period for an annual health assessment and those who died during the period were excluded from the survey, giving a total of 276 eligible clients. Out of the 276 clients, 52.5% (128) responded to the survey that asked them to evaluate their satisfaction with the services received at the clinic and the performance of the clinic's practitioners who interacted with them. For practitioner performance, the percentage of respondents who gave a rating of satisfaction was found to range between 86.3-64.3%, while the percentage of respondents who gave a rating of dissatisfaction ranged from 13.7-35.7%. Overall, the survey found that most aspects of the Integrative Health Clinic's services were rated as satisfactory. The overwhelming satisfaction of clients with

  10. Supporting students in professional socialisation: Guidelines for professional nurses and educators

    Directory of Open Access Journals (Sweden)

    Hester Cathrina (Rina de Swardt

    2017-01-01

    Full Text Available Professional socialisation of nursing students involves learning skills, attitudes, behaviour and professional roles, largely in the clinical area. During clinical accompaniment and reflective discussions with a group of undergraduate Baccalaureate nursing students in South Africa, students reported negative professional socialisation experiences, primarily in the clinical area. Such experiences could influence the quality of patient care. The objective of this study was to develop and validate guidelines to support professional nurses and educators in the professional socialisation of student nurses. Evidence was generated from an exploration and description of the perceptions of professional nurses regarding their role in the professional socialisation of students, the perceptions of nurse educators regarding the teaching and facilitation of professional socialisation of students, and the socialisation experiences of students. Following a sequential mixed-methods design, qualitative data guided the collection of quantitative data. All data and literature directed the development of these guidelines, which experts reviewed and validated according to a set of criteria. These guidelines focus on the clinical, nursing educational institution environment and values and beliefs of the nursing profession. Facilitation of sound work ethics, professional behaviour, cultural and gender awareness, role modelling and the application of a range of teaching strategies is proposed.

  11. Integration of Basic and Clinical Science in the Psychiatry Clerkship.

    Science.gov (United States)

    Wilkins, Kirsten M; Moore, David; Rohrbaugh, Robert M; Briscoe, Gregory W

    2017-06-01

    Integration of basic and clinical science is a key component of medical education reform, yet best practices have not been identified. The authors compared two methods of basic and clinical science integration in the psychiatry clerkship. Two interventions aimed at integrating basic and clinical science were implemented and compared in a dementia conference: flipped curriculum and coteaching by clinician and physician-scientist. The authors surveyed students following each intervention. Likert-scale responses were compared. Participants in both groups responded favorably to the integration format and would recommend integration be implemented elsewhere in the curriculum. Survey response rates differed significantly between the groups and student engagement with the flipped curriculum video was limited. Flipped curriculum and co-teaching by clinician and physician-scientist are two methods of integrating basic and clinical science in the psychiatry clerkship. Student learning preferences may influence engagement with a particular teaching format.

  12. Integrated Energy Design

    DEFF Research Database (Denmark)

    Brunsgaard, Camilla; Dvořáková, Pavla; Wyckmans, Annemie

    2014-01-01

    the development, it is essential that educational institutions foster professionals with such knowledge, skills and competences. An initiative toward this direction is the EUproject of IDES-EDU: “Master and Post-Graduate education and training in multi-disciplinary teams”. The paper describes the necessity...... of more integrated and cross-disciplinary approaches to building design through state-of-the-art of the building sector and educational initiatives in the participating countries in the project, and through theory of design processes. The paper also communicates the results of newly developed cross...

  13. What is the veterinary professional identity? Preliminary findings from web-based continuing professional development in veterinary professionalism.

    Science.gov (United States)

    Armitage-Chan, E; Maddison, J; May, S A

    2016-03-26

    Professionalism and professional skills are increasingly being incorporated into veterinary curricula; however, lack of clarity in defining veterinary professionalism presents a potential challenge for directing course outcomes that are of benefit to the veterinary professional. An online continuing education course in veterinary professionalism was designed to address a deficit in postgraduate support in this area; as part of this course, delegates of varying practice backgrounds participated in online discussions reflecting on the implications of professional skills for their clinical practice. The discussions surrounding the role of the veterinary professional and reflecting on strengths and weaknesses in professional skills were analysed using narrative methodology, which provided an understanding of the defining skills and attributes of the veterinary professional, from the perspectives of those involved (i.e. how vets understood their own career identity). The veterinary surgeon was understood to be an interprofessional team member, who makes clinical decisions in the face of competing stakeholder needs and works in a complex environment comprising multiple and diverse challenges (stress, high emotions, financial issues, work-life balance). It was identified that strategies for accepting fallibility, and those necessary for establishing reasonable expectations of professional behaviour and clinical ability, are poorly developed. British Veterinary Association.

  14. A Qualitative Multi-Case Study of the Influence of Personal and Professional Ethics on the Leadership of Public School Superintendents

    Science.gov (United States)

    McDermott, Brian J.

    2010-01-01

    The purpose of this study is to examine the influence of personal and professional ethics on the leadership of public school superintendents. A multi-case, qualitative research design was used to gather data from four practicing public school superintendents. Transformational leadership theory and the three pillars of ethics of leadership…

  15. Review of Multi-Criteria Decision Aid for Integrated Sustainability Assessment of Urban Water Systems - MCEARD

    Science.gov (United States)

    Integrated sustainability assessment is part of a new paradigm for urban water decision making. Multi-criteria decision aid (MCDA) is an integrative framework used in urban water sustainability assessment, which has a particular focus on utilising stakeholder participation. Here ...

  16. Psychology of the scientist: LXXXI. Professional school and traditional program graduates: comparison on measures of achievement in clinical psychology.

    Science.gov (United States)

    Templer, D I; Tomeo, M E; Pointkowski, S R; Mitroff, D; Niederhauser, R N; Siscoe, K

    2000-06-01

    Clinical psychologists who graduated from traditional programs and those who graduated from professional schools were compared on both scientifically and professionally oriented criteria of achievement and recognition. Upon controlling for year of graduation from a doctoral program, the professional school graduates were less likely to be APA fellows, less likely to be on the editorial board of specified research oriented journals in clinical psychology, less likely to have diplomate status in the American Board of Professional Psychology (ABPP), less likely to have been president of state psychological associations, and less likely to have been APPIC internship directors.

  17. Shared decision-making at the end of life: A focus group study exploring the perceptions and experiences of multi-disciplinary healthcare professionals working in the home setting.

    Science.gov (United States)

    Brogan, Paula; Hasson, Felicity; McIlfatrick, Sonja

    2018-01-01

    Globally recommended in healthcare policy, Shared Decision-Making is also central to international policy promoting community palliative care. Yet realities of implementation by multi-disciplinary healthcare professionals who provide end-of-life care in the home are unclear. To explore multi-disciplinary healthcare professionals' perceptions and experiences of Shared Decision-Making at end of life in the home. Qualitative design using focus groups, transcribed verbatim and analysed thematically. A total of 43 participants, from multi-disciplinary community-based services in one region of the United Kingdom, were recruited. While the rhetoric of Shared Decision-Making was recognised, its implementation was impacted by several interconnecting factors, including (1) conceptual confusion regarding Shared Decision-Making, (2) uncertainty in the process and (3) organisational factors which impeded Shared Decision-Making. Multiple interacting factors influence implementation of Shared Decision-Making by professionals working in complex community settings at the end of life. Moving from rhetoric to reality requires future work exploring the realities of Shared Decision-Making practice at individual, process and systems levels.

  18. Interorganisational Integration: Healthcare Professionals’ Perspectives on Barriers and Facilitators within the Danish Healthcare System

    Directory of Open Access Journals (Sweden)

    Anne Marie Lyngsø

    2016-03-01

    Full Text Available Introduction: Despite many initiatives to improve coordination of patient pathways and intersectoral cooperation, Danish health care is still fragmented, lacking intra- and interorganisational integration. This study explores barriers to and facilitators of interorganisational integration as perceived by healthcare professionals caring for patients with chronic obstructive pulmonary disease within the Danish healthcare system. Methods: Seven focus groups were conducted in January through July 2014 with 21 informants from general practice, local healthcare centres and a pulmonary department at a university hospital in the Capital Region of Denmark. Results and discussion: Our results can be grouped into five influencing areas for interorganisational integration: communication/information transfer, committed leadership, patient engagement, the role and competencies of the general practitioner and organisational culture. Proposed solutions to barriers in each area hold the potential to improve care integration as experienced by individuals responsible for supporting and facilitating it. Barriers and facilitators to integrating care relate to clinical, professional, functional and normative integration. Especially, clinical, functional and normative integration seems fundamental to developing integrated care in practice from the perspective of healthcare professionals.

  19. Multi-omic data integration enables discovery of hidden biological regularities

    DEFF Research Database (Denmark)

    Ebrahim, Ali; Brunk, Elizabeth; Tan, Justin

    2016-01-01

    Rapid growth in size and complexity of biological data sets has led to the 'Big Data to Knowledge' challenge. We develop advanced data integration methods for multi- level analysis of genomic, transcriptomic, ribosomal profiling, proteomic and fluxomic data. First, we show that pairwise integration...... of primary omics data reveals regularities that tie cellular processes together in Escherichia coli: the number of protein molecules made per mRNA transcript and the number of ribosomes required per translated protein molecule. Second, we show that genome- scale models, based on genomic and bibliomic data......, enable quantitative synchronization of disparate data types. Integrating omics data with models enabled the discovery of two novel regularities: condition invariant in vivo turnover rates of enzymes and the correlation of protein structural motifs and translational pausing. These regularities can...

  20. Development of professional expertise in optometry.

    Science.gov (United States)

    Faucher, Caroline

    2011-04-01

    Development of professional expertise is the gradual transition from novice to expert within a profession. Studies on expertise in the profession of optometry have never been published. However, many studies have been performed in other health professions (e.g., nursing, medicine, physical therapy, occupational therapy). This report is an overview of the development of professional expertise that will highlight some applications for optometry. A 5-level scale of professional expertise development, divided into 2 parts, is described. The first part is the progression of students during their professional studies (novice, intermediate, competent). The second part is the professional development occurring during the practice years (advanced, expert). Personal and collective efforts are required to foster the progression toward expertise. Great interest for the profession, motivation, and deliberate practice are individual attitudes that help this progression. The "optometric community of practice," by means of university (professional) training, continuing education, and collaboration between colleagues, also contributes to this process. Professional development is an integral part of the Optometric Oath. Each clinical case is a potential learning experience contributing to one's professional development. Optometrists' attitudes are predominant factors in the progression from one level to another. Copyright © 2011 American Optometric Association. Published by Elsevier Inc. All rights reserved.

  1. Multi-probleemgezinnen met een Roma-achtergrond: waarom verloopt hun integratie moeizaam?

    Directory of Open Access Journals (Sweden)

    Vina Wijkhuijs

    2014-03-01

    Full Text Available Roma multi-problem families in the Netherlands: what hinders their integration?The European Commission has entrusted the EU Member States with the preparation of a national Roma integration strategy in order to address more effectively the challenges of the inclusion of Europe’s largest ethnic minority. This article offers insight into the complex situation of Roma communities in the Netherlands on the basis of the following question: What is known about the problems that occur in families with a Roma background and what recommendations can be made to promote their integration? This article is based on 33 interviews with professionals from different welfare organizations and social services. What follows is that intervention is necessary in certain families, but to accomplish this, problems relating to the attitudes of these families and inconsistencies in care and (law enforcement policies must be overcome. Given the highly complex nature of these issues, the integration of Roma multi problem families requires a long-term and, most of all, consistent approach.Multi-probleemgezinnen met een Roma-achtergrond: waarom verloopt hun integratie moeizaam?De Europese Commissie heeft de EU-lidstaten opgedragen een aanpak te ontwikkelen voor de integratie van Roma, zijnde de grootste etnische minderheidsgroep in Europa. Deze bijdrage belicht de situatie in Nederland aan de hand van de volgende vraag: Wat is onder professionals bekend over de problemen die zich bij gezinnen met een Roma-achtergrond voordoen en welke aanbevelingen kunnen worden gedaan om hun integratie te bevorderen? Wat volgt is dat interventie in bepaalde gezinnen noodzakelijk is, maar dat de aanpak stuit op de houding en leefwijze van deze gezinnen en op inconsistenties in de hulpverlening en handhaving. Wat nodig is, is aandacht voor het bijzondere van de problematiek zonder deze te verbijzonderen, en versterking van de ketenregie.

  2. The Quality of Clinical Information in Adverse Drug Reaction Reports by Patients and Healthcare Professionals: A Retrospective Comparative Analysis.

    Science.gov (United States)

    Rolfes, Leàn; van Hunsel, Florence; van der Linden, Laura; Taxis, Katja; van Puijenbroek, Eugène

    2017-07-01

    Clinical information is needed to assess the causal relationship between a drug and an adverse drug reaction (ADR) in a reliable way. Little is known about the level of relevant clinical information about the ADRs reported by patients. The aim was to determine to what extent patients report relevant clinical information about an ADR compared with their healthcare professional. A retrospective analysis of all ADR reports on the same case, i.e., cases with a report from both the patient and the patient's healthcare professional, selected from the database of the Dutch Pharmacovigilance Center Lareb, was conducted. The extent to which relevant clinical information was reported was assessed by trained pharmacovigilance assessors, using a structured tool. The following four domains were assessed: ADR, chronology, suspected drug, and patient characteristics. For each domain, the proportion of reported information in relation to information deemed relevant was calculated. An average score of all relevant domains was determined and categorized as poorly (≤45%), moderately (from 46 to 74%) or well (≥75%) reported. Data were analyzed using a paired sample t test and Wilcoxon signed rank test. A total of 197 cases were included. In 107 cases (54.3%), patients and healthcare professionals reported a similar level of clinical information. Statistical analysis demonstrated no overall differences between the groups (p = 0.126). In a unique study of cases of ADRs reported by patients and healthcare professionals, we found that patients report clinical information at a similar level as their healthcare professional. For an optimal pharmacovigilance, both healthcare professionals and patient should be encouraged to report.

  3. [Care and specialized clinical follow-up of nursing professionals who have been victims of accidents with biological material].

    Science.gov (United States)

    Pimenta, Flaviana Regina; Ferreira, Milene Dias; Gir, Elucir; Hayashida, Miyeko; Canini, Silvia Rita Marin da Silva

    2013-02-01

    This cross-sectional study aimed to evaluate the conduct of nursing professionals who had been victims of accidents with biological material in a teaching hospital in the interior of the state of São Paulo, Brazil, regarding their care and specialized clinical follow-up. The study population consisted of 1,215 nursing professionals, who were interviewed individually between 2010 and 2011. Of the 1,215 nursing professionals interviewed, 636 (52.3%) reported having experienced accidents with biological material; of this population, 182 (28.6%) didn't sought specialized care. The most frequent reason reported for not seeking care was believing that it was a low-risk accident. The reasons professionals do not seek care and do not complete treatment and the clinical follow-up can contribute to strategies to increase professionals' adherence to prophylaxis measures after occupational exposure to biological material.

  4. Systematic collection of patient reported outcome research data: A checklist for clinical research professionals.

    Science.gov (United States)

    Wehrlen, Leslie; Krumlauf, Mike; Ness, Elizabeth; Maloof, Damiana; Bevans, Margaret

    2016-05-01

    Understanding the human experience is no longer an outcome explored strictly by social and behavioral researchers. Increasingly, biomedical researchers are also including patient reported outcomes (PROs) in their clinical research studies not only due to calls for increased patient engagement in research but also healthcare. Collecting PROs in clinical research studies offers a lens into the patient's unique perspective providing important information to industry sponsors and the FDA. Approximately 30% of trials include PROs as primary or secondary endpoints and a quarter of FDA new drug, device and biologic applications include PRO data to support labeling claims. In this paper PRO, represents any information obtained directly from the patient or their proxy, without interpretation by another individual to ascertain their health, evaluate symptoms or conditions and extends the reference of PRO, as defined by the FDA, to include other sources such as patient diaries. Consumers and clinicians consistently report that PRO data are valued, and can aide when deciding between treatment options; therefore an integral part of clinical research. However, little guidance exists for clinical research professionals (CRPs) responsible for collecting PRO data on the best practices to ensure quality data collection so that an accurate assessment of the patient's view is collected. Therefore the purpose of this work was to develop and validate a checklist to guide quality collection of PRO data. The checklist synthesizes best practices from published literature and expert opinions addressing practical and methodological challenges CRPs often encounter when collecting PRO data in research settings. Published by Elsevier Inc.

  5. MULTI-SCALE SEGMENTATION OF HIGH RESOLUTION REMOTE SENSING IMAGES BY INTEGRATING MULTIPLE FEATURES

    Directory of Open Access Journals (Sweden)

    Y. Di

    2017-05-01

    Full Text Available Most of multi-scale segmentation algorithms are not aiming at high resolution remote sensing images and have difficulty to communicate and use layers’ information. In view of them, we proposes a method of multi-scale segmentation of high resolution remote sensing images by integrating multiple features. First, Canny operator is used to extract edge information, and then band weighted distance function is built to obtain the edge weight. According to the criterion, the initial segmentation objects of color images can be gained by Kruskal minimum spanning tree algorithm. Finally segmentation images are got by the adaptive rule of Mumford–Shah region merging combination with spectral and texture information. The proposed method is evaluated precisely using analog images and ZY-3 satellite images through quantitative and qualitative analysis. The experimental results show that the multi-scale segmentation of high resolution remote sensing images by integrating multiple features outperformed the software eCognition fractal network evolution algorithm (highest-resolution network evolution that FNEA on the accuracy and slightly inferior to FNEA on the efficiency.

  6. Coordinated Control of Multi-terminal DC Grid for Wind Power Integration

    DEFF Research Database (Denmark)

    Hao, Yu; Zhao, Haoran; Wu, Qiuwei

    2016-01-01

    Multi-terminal HVDC (MTDC) technology using voltage source converter (VSC) is a good option for wind power integration. Compared with point to point DC connection, MTDC provide better controllability based on different control strategies. In this paper, proportional-integral (PI) controllers...... with tuned PI parameters are designed to coordinate DC flow among the DC grid with good dynamic performance. In order to overcome the disadvantages of the conventional PI control, a simple adaptive PI control strategy is proposed based on the system transfer function. Case studies were conducted with PowerFactory....

  7. Evaluating Patient Perspectives of Provider Professionalism on Twitter in an Academic Obstetrics and Gynecology Clinic: Patient Survey

    Science.gov (United States)

    Stansfield, R Brent; Opipari, AnneMarie; Hammoud, Maya M

    2018-01-01

    Background One-third of Americans use social media websites as a source of health care information. Twitter, a microblogging site that allows users to place 280-character posts—or tweets—on the Web, is emerging as an important social media platform for health care. However, most guidelines on medical professionalism on social media are based on expert opinion. Objective This study sought to examine if provider Twitter profiles with educational tweets were viewed as more professional than profiles with personal tweets or a mixture of the two, and to determine the impact of provider gender on perceptions of professionalism in an academic obstetrics and gynecology clinic. Methods This study randomized obstetrics and gynecology patients at the University of Michigan Von Voigtlander Clinic to view one of six medical provider Twitter profiles, which differed in provider gender and the nature of tweets. Each participant answered 10 questions about their perception of the provider’s professionalism based on the Twitter profile content. Results The provider profiles with educational tweets alone received higher mean professionalism scores than profiles with personal tweets. Specifically, the female and male provider profiles with exclusively educational tweets had the highest and second highest overall mean professionalism ratings at 4.24 and 3.85, respectively. In addition, the female provider profiles received higher mean professionalism ratings than male provider profiles with the same content. The female profile with mixed content received a mean professionalism rating of 3.38 compared to 3.24 for the male mixed-content profile, and the female profile with only personal content received a mean professionalism rating of 3.68 compared to 2.68 for the exclusively personal male provider profile. Conclusions This study showed that in our obstetrics and gynecology clinic, patients perceived providers with educational profiles as more professional than those with a

  8. Evaluation on Biofilter in Recirculating Integrated Multi-Trophic Aquaculture

    Directory of Open Access Journals (Sweden)

    S. Sumoharjo

    2013-06-01

    Full Text Available Integrated multi-trophic aquaculture pays more attention as a bio-integrated food production system that serves as a model of sustainable aquaculture, minimizes waste discharge, increases diversity and yields multiple products. The objectives of this research were to analyze the efficiency of total ammonia nitrogen biofiltration and its effect on carrying capacity of fish rearing units. Pilot-scale bioreactor was designed with eight run-raceways (two meters of each that assembled in series. Race 1-3 were used to stock silky worm (Tubifex sp as detrivorous converter, then race 4-8 were used to plant three species of leaf-vegetable as photoautotrophic converters, i.e; spinach (Ipomoea reptana, green mustard (Brassica juncea and basil (Ocimum basilicum. The three plants were placed in randomized block design based on water flow direction. Mass balance of nutrient analysis, was applied to figure out the efficiency of bio-filtration and its effect on carrying capacity of rearing units. The result of the experiment showed that 86.5 % of total ammonia nitrogen removal was achieved in 32 days of culturing period. This efficiency able to support the carrying capacity of the fish tank up to 25.95 kg/lpm with maximum density was 62.69 kg/m3 of fish biomass productionDoi: http://dx.doi.org/10.12777/ijse.4.2.2013.80-85 [How to cite this article: Sumoharjo, S.  and Maidie, A. (2013. Evaluation on Biofilter in Recirculating Integrated Multi-Trophic Aquaculture.  International Journal of  Science and Engineering, 4(2,80-85. Doi: http://dx.doi.org/10.12777/ijse.4.2.2013.80-85

  9. Is emergency management an integrated element of business continuity management? A case study with security professionals in Western Australia.

    Science.gov (United States)

    Frohde, Kenny; Brooks, David J

    Emergency management (EM) and business continuity management (BCM) frameworks incorporate various strategic and operational measures. Defined within a number of national and international standards and guidelines, such concepts may be integrated within one another to provide increased resilience to disruptive events. Nevertheless, there is a degree of dispute regarding concept integration among security and EM professionals and bodies of knowledge. In line with cognitive psychology exemplar-based concepts, such disputes may be associated with a lack of precision in communality in the approach to EM and BCM. This paper presents a two-stage study, where stage 1 critiqued national and international literature and stage 2 applied semi-structured interviews with security managers in Western Australia. Findings indicate the existence of contradictory views on EM and its integration within BCM. As such, this study concludes that EM is considered a vital component of BCM by the majority of security managers. However, there is broader dispute regarding its degree of integration. Understanding the underpinnings of such disputes will aid in raising the standards and application of professionalism within security, EM and BCM domains, supporting clarification and definition of professional boundaries.

  10. Integrating Professional Development into STEM Graduate Programs: Student-Centered Programs for Career Preparation

    Science.gov (United States)

    Lautz, L.; McCay, D.; Driscoll, C. T.; Glas, R. L.; Gutchess, K. M.; Johnson, A.; Millard, G.

    2017-12-01

    Recognizing that over half of STEM Ph.D. graduates are finding work outside of academia, a new, NSF-funded program at Syracuse University, EMPOWER (or Education Model Program on Water-Energy Research) is encouraging its graduate students to take ownership of their graduate program and design it to meet their anticipated needs. Launched in 2016, EMPOWER's goal is to prepare graduate students for careers in the water-energy field by offering targeted workshops, professional training coursework, a career capstone experience, a professional development mini-grant program, and an interdisciplinary "foundations" seminar. Through regular student feedback and program evaluation, EMPOWER has learned some important lessons this first year: career options and graduate students' interests are diverse, requiring individualized programs designed to meet the needs of prospective employers and employees; students need exposure to the range of careers in their field to provide a roadmap for designing their own graduate school experience; effective programs nurture a culture that values professional development thereby giving students permission to pursue career paths and professional development opportunities that meet their own needs and interests; and existing university resources support the effective and efficient integration of professional development activities into graduate programs. Many of the positive outcomes experienced by EMPOWER students may be achieved in departmental graduate programs with small changes to their graduate curricula.

  11. Profits or Professionalism? On Designing Professional Service Firms

    NARCIS (Netherlands)

    M.W. Lander (Michel)

    2012-01-01

    textabstractResearch on professional service firms (PSFs) did not come off the ground until recently. This lack of attention is surprising, given their integral role in contemporary knowledge-based economies. In this dissertation, I focus on two professional industries: law and accounting.

  12. Multi-agent system for energy resource scheduling of integrated microgrids in a distributed system

    International Nuclear Information System (INIS)

    Logenthiran, T.; Srinivasan, Dipti; Khambadkone, Ashwin M.

    2011-01-01

    This paper proposes a multi-agent system for energy resource scheduling of an islanded power system with distributed resources, which consists of integrated microgrids and lumped loads. Distributed intelligent multi-agent technology is applied to make the power system more reliable, efficient and capable of exploiting and integrating alternative sources of energy. The algorithm behind the proposed energy resource scheduling has three stages. The first stage is to schedule each microgrid individually to satisfy its internal demand. The next stage involves finding the best possible bids for exporting power to the network and compete in a whole sale energy market. The final stage is to reschedule each microgrid individually to satisfy the total demand, which is the addition of internal demand and the demand from the results of the whole sale energy market simulation. The simulation results of a power system with distributed resources comprising three microgrids and five lumped loads show that the proposed multi-agent system allows efficient management of micro-sources with minimum operational cost. The case studies demonstrate that the system is successfully monitored, controlled and operated by means of the developed multi-agent system. (author)

  13. Multi-agent system for energy resource scheduling of integrated microgrids in a distributed system

    Energy Technology Data Exchange (ETDEWEB)

    Logenthiran, T.; Srinivasan, Dipti; Khambadkone, Ashwin M. [Department of Electrical and Computer Engineering, National University of Singapore, 4 Engineering Drive 3, Singapore 117576 (Singapore)

    2011-01-15

    This paper proposes a multi-agent system for energy resource scheduling of an islanded power system with distributed resources, which consists of integrated microgrids and lumped loads. Distributed intelligent multi-agent technology is applied to make the power system more reliable, efficient and capable of exploiting and integrating alternative sources of energy. The algorithm behind the proposed energy resource scheduling has three stages. The first stage is to schedule each microgrid individually to satisfy its internal demand. The next stage involves finding the best possible bids for exporting power to the network and compete in a whole sale energy market. The final stage is to reschedule each microgrid individually to satisfy the total demand, which is the addition of internal demand and the demand from the results of the whole sale energy market simulation. The simulation results of a power system with distributed resources comprising three microgrids and five lumped loads show that the proposed multi-agent system allows efficient management of micro-sources with minimum operational cost. The case studies demonstrate that the system is successfully monitored, controlled and operated by means of the developed multi-agent system. (author)

  14. The effect of integrated emotion-oriented care versus usual care on elderly persons with dementia in the nursing home and on nursing assistants: a randomized clinical trial

    NARCIS (Netherlands)

    Finnema, E.J.; Dr�es, R.M.; Ettema, T.P.; Ooms, M.E.; Adèr, H.J.; Ribbe, M.W.; van Tilburg, W.

    2005-01-01

    Objectives: To examine the effect of integrated emotion-oriented care on nursing home residents with dementia and nursing assistants. Design: A multi-site randomized clinical trial with matched groups, and measurements at baseline and after seven months. Setting: Sixteen psychogeriatric wards in

  15. The effect of integrated emotion-oriented care versus usual care on elderly persons with dementia in the nursing home and on nursing assistants: a randomized clinical trial

    NARCIS (Netherlands)

    Finnema, E.J.; Dr�es, R.M.; Ettema, T.P.; Ooms, M.E.; Adèr, H.J.; Ribbe, M.W.; Tilburg, van W.

    2005-01-01

    OBJECTIVES: To examine the effect of integrated emotion-oriented care on nursing home residents with dementia and nursing assistants. DESIGN: A multi-site randomized clinical trial with matched groups, and measurements at baseline and after seven months. SETTING: Sixteen psychogeriatric wards in

  16. Using the Repertory Grid Technique to Examine Trainee Clinical Psychologists' Construal of Their Personal and Professional Development.

    Science.gov (United States)

    Hill, Katy; Wittkowski, Anja; Hodgkinson, Emma; Bell, Richard; Hare, Dougal J

    2016-09-01

    The repertory grid technique was used to explore how 26 third-year trainee clinical psychologists construed their personal and professional selves over the course of training and into the future. Each trainee completed a demographic questionnaire and a repertory grid with 10 elements: four 'personal self' elements, four 'professional self' elements and two 'qualified clinical psychologist' elements. They then rated the 10 elements on 10 bipolar constructs of their choosing. Trainees' personal and professional selves were construed to be similar to each other. Trainees had low self-esteem and reported currently feeling anxious, stressed, unsettled and lacking an appropriate work-life balance. These difficulties were attributed to the demands of training and were expected to resolve once training was completed with future selves being construed as similar to ideal selves. Suggestions for future research with improved methodology are made, and the implications of the findings for trainees, training providers and employers of newly qualified clinical psychologists are given. The overall implication being that stress in training is normative and the profession has a duty to normalize this and ensure that self-care and personal development are recognized as core competencies of the clinical psychologist for the benefit of its members and their clients. Copyright © 2015 John Wiley & Sons, Ltd. Clinical psychology trainees experience training as demanding and stressful, which negatively impacts on their personal and professional self-image and self-esteem. However, they are optimistic that they will become more like their ideal self in the future. Stress in clinical training (and beyond) is normative, and thus, personal development and self-care should be recognized as clinical psychologist's core competencies. Copyright © 2015 John Wiley & Sons, Ltd.

  17. Knowledge and Practices of Toxoplasmosis among Clinical Laboratory Professionals: A Cross-Sectional Study in Durango, Mexico.

    Science.gov (United States)

    Alvarado-Esquivel, Cosme; Sánchez-Anguiano, Luis Francisco; Berumen-Segovia, Luis Omar; Hernández-Tinoco, Jesús; Rico-Almochantaf, Yazmin Del Rosario; Cisneros-Camacho, Alfredo; Cisneros-Martínez, Jorge Arturo

    2017-11-18

    Background : The aim of this study was to determine the level of knowledge and practices about toxoplasmosis in a sample of clinical laboratory professionals in Mexico. Methods : 192 clinical laboratory professionals were surveyed. They were asked about (1) Toxoplasma gondii ; (2) clinical manifestations, diagnosis, treatment, and epidemiology of toxoplasmosis; and (3) their practices with respect to toxoplasmosis. Results : The range of animals infected by T. gondii was known by 44.8% of participants. Clinical aspects of toxoplasmosis were known by up to 44.3% of subjects. Correct answers about the interpretation of serological markers of T. gondii infection were provided by up to 32.8% of participants. A minority (32.2%) of participants knew about a high number of false positive results of anti- T. gondii IgM antibody tests. Most participants (90.1%) did not know what the anti- T. gondii IgG avidity test was. Up to 55.7% of participants provided incorrect answers about the interpretation of serology tests for the treatment of pregnant women. Common routes of T. gondii infection were known by toxoplasmosis and a limited practice of laboratory tests among the professionals surveyed.

  18. Ethically-based clinical decision-making in physical therapy: process and issues.

    Science.gov (United States)

    Finch, Elspeth; Geddes, E Lynne; Larin, Hélène

    2005-01-01

    The identification and consideration of relevant ethical issues in clinical decision-making, and the education of health care professionals (HCPs) in these skills are key factors in providing quality health care. This qualitative study explores the way in which physical therapists (PTs) integrate ethical issues into clinical practice decisions and identifies ethical themes used by PTs. A purposive sample of eight PTs was asked to describe a recent ethically-based clinical decision. Transcribed interviews were coded and themes identified related to the following categories: 1) the integration of ethical issues in the clinical decision-making process, 2) patient welfare, 3) professional ethos of the PT, and 4) health care economics and business practices. Participants readily described clinical situations involving ethical issues but rarely identified specific conflicting ethical issues in their description. Ethical dilemmas were more frequently resolved when there were fewer emotional sequelae associated with the dilemma, and the PT had a clear understanding of professional ethos, valued patient autonomy, and explored a variety of alternative actions before implementing one. HCP students need to develop a clear professional ethos and an increased understanding of the economic factors that will present ethical issues in practice.

  19. Faithful but Different: Clinical Social Workers Speak Out about Career Motivation and Professional Values

    Science.gov (United States)

    Bradley, Carolyn; Maschi, Tina; O'Brien, Helen; Morgen, Keith; Ward, Kelly

    2012-01-01

    The purpose of this study was to describe licensed clinical social workers' (LCSWs) professional motivation to pursue a social work career and the decision to enter clinical practice. It used a probability sample of 245 New Jersey LCSWs and the Social Work Values Survey as part of an anonymous self-administered mail survey. Descriptive analyses…

  20. Multi-channel integrated circuits for the detection and measurement of ionizing radiation

    International Nuclear Information System (INIS)

    Engel, G.L.; Duggireddi, N.; Vangapally, V.; Elson, J.M.; Sobotka, L.G.; Charity, R.J.

    2011-01-01

    The Integrated Circuits (IC) Design Research Laboratory at Southern Illinois University Edwardsville (SIUE) has collaborated with the Nuclear Reactions Group at Washington University (WU) to develop a family of multi-channel integrated circuits. To date, the collaboration has successfully produced two micro-chips. The first was an analog shaped and peak sensing chip with on-board constant-fraction discriminators and sparsified readout. This chip is known as Heavy-Ion Nuclear Physics-16 Channel (HINP16C). The second chip, christened PSD8C, was designed to logically complement (in terms of detector types) the HINP16C chip. Pulse Shape Discrimination-8 Channel (PSD8C), featuring three settable charge integration windows per channel, performs pulse shape discrimination (PSD). This paper summarizes the design, capabilities, and features of the HINP16C and PSD8C ICs. It proceeds to discuss the modifications, made to the ICs and their associated systems, which have attempted to improve ease of use, increase performance, and extend capabilities. The paper concludes with a brief discussion of what may be the next chip (employing a multi-sampling scheme) to be added to our CMOS ASIC 'tool box' for radiation detection instrumentation.

  1. Professional excellence and career advancement in nursing: a conceptual framework for clinical leadership development.

    Science.gov (United States)

    Adeniran, Rita Kudirat; Bhattacharya, Anand; Adeniran, Anthony A

    2012-01-01

    Increasingly, stakeholders in the health care community are recognizing nursing as key to solving the nation's health care issues. This acknowledgment provides a unique opportunity for nursing to demonstrate leadership by developing clinical nurse leaders to collaborate with the multidisciplinary care team in driving evidence-based, safe quality, cost-effective health care services. One approach for nursing success is standardizing the entry-level education for nurses and developing a uniform professional development and career advancement trajectory with appropriate incentives to encourage participation. A framework to guide and provide scientific evidence of how frontline nurses can be engaged will be paramount. The model for professional excellence and career advancement provides a framework that offers a clear path for researchers to examine variables influencing nurses' professional development and career advancement in a systematic manner. Professional Excellence and Career Advancement in Nursing underscores professional preparedness of a registered nurse as central to leadership development. It also describes the elements that influence nurses' participation in professional development and career advancement under 4 main categories emphasizing mentorship and self-efficacy as essential variables.

  2. Potential barriers and facilitators for implementation of an integrated care pathway for hearing-impaired persons: an exploratory survey among patients and professionals

    Directory of Open Access Journals (Sweden)

    Verschuure Hans

    2007-04-01

    Full Text Available Abstract Background Because of the increasing costs and anticipated shortage of Ear Nose and Throat (ENT specialists in the care for hearing-impaired persons, an integrated care pathway that includes direct hearing aid provision was developed. While this direct pathway is still under investigation, in a survey we examined expectations and potential barriers and facilitators towards this direct pathway, of patients and professionals involved in the pathway. Methods Two study populations were assessed: members of the health professions involved in the care pathway for hearing-impaired persons (general practitioners (GPs, hearing aid dispensers, ENT-specialists and clinical audiologists and persons with hearing complaints. We developed a comprehensive semi-structured questionnaire for the professionals, regarding expectations, barriers, facilitators and conditions for implementation. We developed two questionnaires for persons with hearing complaints, both regarding evaluations and preferences, and administered them after they had experienced two key elements of the direct pathway: the triage and the hearing aid fitting. Results On average GPs and hearing aid dispensers had positive expectations towards the direct pathway, while ENT-specialists and clinical audiologists had negative expectations. Professionals stated both barriers and facilitators towards the direct pathway. Most professionals either supported implementation of the direct pathway, provided that a number of conditions were satisfied, or did not support implementation, unless roughly the same conditions were satisfied. Professionals generally agreed on which conditions need to be satisfied. Persons with hearing complaints evaluated the present referral pathway and the new direct pathway equally. Many, especially older, participants stated however that they would still visit the GP and ENT-specialist, even when this would not be necessary for reimbursement of the hearing aid, and

  3. Pursuing Improvement in Clinical Reasoning: The Integrated Clinical Education Theory.

    Science.gov (United States)

    Jessee, Mary Ann

    2018-01-01

    The link between clinical education and development of clinical reasoning is not well supported by one theoretical perspective. Learning to reason during clinical education may be best achieved in a supportive sociocultural context of nursing practice that maximizes reasoning opportunities and facilitates discourse and meaningful feedback. Prelicensure clinical education seldom incorporates these critical components and thus may fail to directly promote clinical reasoning skill. Theoretical frameworks supporting the development of clinical reasoning during clinical education were evaluated. Analysis of strengths and gaps in each framework's support of clinical reasoning development was conducted. Commensurability of philosophical underpinnings was confirmed, and complex relationships among key concepts were elucidated. Six key concepts and three tenets comprise an explanatory predictive theory-the integrated clinical education theory (ICET). ICET provides critical theoretical support for inquiry and action to promote clinical education that improves development of clinical reasoning skill. [J Nurs Educ. 2018;57(1):7-13.]. Copyright 2018, SLACK Incorporated.

  4. Managing Ethical Difficulties in Healthcare: Communicating in Inter-professional Clinical Ethics Support Sessions.

    Science.gov (United States)

    Grönlund, Catarina Fischer; Dahlqvist, Vera; Zingmark, Karin; Sandlund, Mikael; Söderberg, Anna

    2016-12-01

    Several studies show that healthcare professionals need to communicate inter-professionally in order to manage ethical difficulties. A model of clinical ethics support (CES) inspired by Habermas' theory of discourse ethics has been developed by our research group. In this version of CES sessions healthcare professionals meet inter-professionally to communicate and reflect on ethical difficulties in a cooperative manner with the aim of reaching communicative agreement or reflective consensus. In order to understand the course of action during CES, the aim of this study was to describe the communication of value conflicts during a series of inter-professional CES sessions. Ten audio- and video-recorded CES sessions were conducted over eight months and were analyzed by using the video analysis tool Transana and qualitative content analysis. The results showed that during the CES sessions the professionals as a group moved through the following five phases: a value conflict expressed as feelings of frustration, sharing disempowerment and helplessness, the revelation of the value conflict, enhancing realistic expectations, seeing opportunities to change the situation instead of obstacles. In the course of CES, the professionals moved from an individual interpretation of the situation to a common, new understanding and then to a change in approach. An open and permissive communication climate meant that the professionals dared to expose themselves, share their feelings, face their own emotions, and eventually arrive at a mutual shared reality. The value conflict was not only revealed but also resolved.

  5. A Multi-Agent Based Energy Management Solution for Integrated Buildings and Microgrid System

    DEFF Research Database (Denmark)

    Anvari-Moghaddam, Amjad; Rahimi-Kian, Ashkan; Mirian, Maryam S.

    2017-01-01

    -reflex to complex learning agents are designed and implemented to cooperate with each other to reach an optimal operating strategy for the mentioned integrated energy system (IES) while meeting the system’s objectives and related constraints. The optimization process for the EMS is defined as a coordinated......In this paper, an ontology-driven multi-agent based energy management system (EMS) is proposed for monitoring and optimal control of an integrated homes/buildings and microgrid system with various renewable energy resources (RESs) and controllable loads. Different agents ranging from simple...... distributed generation (DG) and demand response (DR) management problem within the studied environment and is solved by the proposed agent-based approach utilizing cooperation and communication among decision agents. To verify the effectiveness and applicability of the proposed multi-agent based EMS, several...

  6. Supporting Placement Supervision in Clinical Exercise Physiology

    Science.gov (United States)

    Sealey, Rebecca M.; Raymond, Jacqueline; Groeller, Herb; Rooney, Kieron; Crabb, Meagan; Watt, Kerrianne

    2015-01-01

    The continued engagement of the professional workforce as supervisors is critical for the sustainability and growth of work-integrated learning activities in university degrees. This study investigated factors that influence the willingness and ability of clinicians to continue to supervise clinical exercise physiology work-integrated learning…

  7. Integrated B1+ Mapping for Hyperpolarized 13C MRI in a Clinical Setup using Multi-Channel Receive Arrays

    DEFF Research Database (Denmark)

    Hansen, Rie Beck; Shin, Peter J.; Gordon, Jeremy W.

    inhomogeneous transmit coils, and because kinetic modeling based on incorrect flip angles can lead to incorrect rate constant estimations. This study demonstrates the feasibility of integrated B1+ mapping for large volume thermal and hyperpolarized phantoms in a clinical setup using a clamshell transmit coil...... and a 16-channel receive array, and a 3D stack-of-spirals sequence. Phase-sensitive coil-combination was achieved using ESPIRiT....

  8. GP leadership in clinical commissioning groups: a qualitative multi-case study approach across England.

    Science.gov (United States)

    Marshall, Martin; Holti, Richard; Hartley, Jean; Matharu, Tatum; Storey, John

    2018-06-01

    Clinical commissioning groups (CCGs) were established in England in 2013 to encourage GPs to exert greater influence over the processes of service improvement and redesign in the NHS. Little is known about the extent and the ways in which GPs have assumed these leadership roles. To explore the nature of clinical leadership of GPs in CCGs, and to examine the enablers and barriers to implementing a policy of clinical leadership in the NHS. A qualitative multi-case study approach in six localities across England. The case studies were purposefully sampled to represent different geographical localities and population demographics, and for their commitment to redesigning specified clinical or service areas. Data were collected from the case study CCGs and their partner organisations using a review of relevant documents, semi-structured individual or group interviews, and observations of key meetings. The data were analysed thematically and informed by relevant theories. GPs prefer a collaborative style of leadership that may be unlikely to produce rapid or radical change. Leadership activities are required at all levels in the system from strategy to frontline delivery, and the leadership behaviours of GPs who are not titular leaders are as important as formal leadership roles. A new alliance is emerging between clinicians and managers that draws on their different skillsets and creates new common interests. The uncertain policy environment in the English NHS is impacting on the willingness and the focus of GP leaders. GPs are making an important contribution as leaders of health service improvement and redesign but there are significant professional and political barriers to them optimising a leadership role. © British Journal of General Practice 2018.

  9. Mapping the interprofessional education landscape for students on rural clinical placements: an integrative literature review.

    Science.gov (United States)

    Walker, Lorraine; Cross, Merylin; Barnett, Tony

    2018-05-01

    Interprofessional collaboration and effective teamwork are core to optimising rural health outcomes; however, little is known about the opportunities available for interprofessional education (IPE) in rural clinical learning environments. This integrative literature review addresses this deficit by identifying, analysing and synthesising the research available about the nature of and potential for IPE provided to undergraduate students undertaking rural placements, the settings and disciplines involved and the outcomes achieved. An integrative review method was adopted to capture the breadth of evidence available about IPE in the rural context. This integrative review is based on a search of nine electronic databases: CINAHL, Cochrane Library, EMBASE, MEDLINE, ProQuest, PubMed, SCOPUS, Web of Science and Google Scholar. Search terms were adapted to suit those used by different disciplines and each database and included key words related to IPE, rurality, undergraduate students and clinical placement. The inclusion criteria included primary research and reports of IPE in rural settings, peer reviewed, and published in English between 2000 and mid-2016. This review integrates the results of 27 primary research studies undertaken in seven countries: Australia, Canada, USA, New Zealand, the Philippines, South Africa and Tanzania. Despite geographical, cultural and health system differences, all of the studies reviewed were concerned with developing collaborative, interprofessional practice-ready graduates and adopted a similar mix of research methods. Overall, the 27 studies involved more than 3800 students (range 3-1360) from 36 disciplinary areas, including some not commonly associated with interprofessional education, such as theology. Interprofessional education was provided in a combination of university and rural placement settings including hospitals, community health services and other rural venues. The education activities most frequently utilised were

  10. Recognition of Core Elements of Medical Professionalism among Medical Students and Faculty Members

    Directory of Open Access Journals (Sweden)

    irdous Jahan

    2016-05-01

    Full Text Available Objectives: Medical students and future physicians have chosen to pursue a profession that requires personal integrity, compassion and a constant awareness of the commitment made by them. Professionalism includes personal behaviors, knowledge, and competency. It includes the attitudes and values one holds and that run through the profession as a whole. Medical students learn professionalism during the course by either direct teaching or experiential learning. We conducted this study to estimate the self-reported level of practice of the core elements of professionalism by medical students and medical faculty and compared the two groups. Methods: One-hundred and nine students and 83 faculty members of Oman Medical College completed a professionalism questionnaire. The survey questions related to core elements of professionalism and were grouped under professional knowledge, professional skills, professional attitude, and qualities essential for professionalism. Results: The response rate was 65.6% (109 of 166 among students and 75.5% (83 of 110 from faculty members. Response to the questions on professional skills between the student and faculty group was significantly different (p < 0.001. Similarly, there was a significant difference in the responses related to professional attitude between the student and faculty group (p < 0.001. Students and faculty members have a significant difference in opinion regarding up to date knowledge of basic and clinical sciences and clinical competency (p = 0.024. Similarly, significant differences in opinion regarding up to date knowledge of basic and clinical sciences and clinical competency in clinical and basic sciences faculty members (p = 0.001. Students identified good communication skills (82.6%, and faculty staff identified up to date professional knowledge (62.7% as the most important aspect of professionalism. Conclusions: Both students and teaching faculty agreed that the top most professional

  11. Conflicts between healthcare professionals and families of a multi-ethnic patient population during critical care: an ethnographic study.

    Science.gov (United States)

    Van Keer, Rose-Lima; Deschepper, Reginald; Francke, Anneke L; Huyghens, Luc; Bilsen, Johan

    2015-12-22

    Conflicts during communication in multi-ethnic healthcare settings is an increasing point of concern as a result of societies' increased ethno-cultural diversity. We can expect that conflicts are even more likely to arise in situations where difficult medical decisions have to be made, such as critical medical situations in hospital. However, in-depth research on this topic is rather scarce. During critical care patients are often unable to communicate. We have therefore investigated factors contributing to conflicts between healthcare professionals and family members from ethnic minority groups in critical medical situations in hospital. Ethnographic fieldwork was done in one intensive care unit of a multi-ethnic urban hospital in Belgium over 6 months (January 2014 to June 2014). Data were collected through negotiated interactive observation, in-depth interviews with healthcare professionals, from patients' medical records, and by making notes in a logbook. Data were analysed by using grounded theory procedures. Conflicts were essentially related to differences in participants' views on what constitutes 'good care' based on different care approaches. Healthcare professionals' views on good care were based predominantly on a biomedical care model, whereas families' views on good care were mainly inspired by a holistic lifeworld-oriented approach. Giving good care, from the healthcare professionals' point of view, included great attention to regulations, structured communication, and central decision making. On the other hand, good care from the families' point of view included seeking exhaustive information, and participating in end-of-life decision making. Healthcare professionals' biomedical views on offering good care were strengthened by the features of the critical care context whereas families' holistic views on offering good care were reinforced by the specific characteristics of families' ethno-familial care context, including their different ethno

  12. [Establishing the idea of holistic integrative medicine, optimizing the quality of health care service in prevention and treatment].

    Science.gov (United States)

    Sun, Xing-guo

    2015-07-01

    Under background of reductionism in the modern science, physiology and medicine are stepwise refined into system, organ, disease, cell and gene etc. Although clinical medicine, only service in whole human object, obviously brought tremendous progress, it also appeared obvious defects and limits at the same time. Professionalized and specialized medicine not only needs to be integrated from basics to clinical fields, but also from prevention, health management, clinical treatment and functional rehabilitation medicine. People are indivisible organic whole. Professionalization, translation and integration must be combined. In order to provide the best quality and optimized medical service for the Chinese people and to lead in the world, we have to strengthen professional and technical knowledge, and have to establish the holistic integrative medical philosophy for physiology and medicine too.

  13. Multi-channel normal speed gated integrator in the measurement of the laser scattering light energy

    International Nuclear Information System (INIS)

    Yang Dong; Yu Xiaoqi; Hu Yuanfeng

    2005-01-01

    With the method of integration in a limited time, a Multi-channel normal speed gated integrator based on VXI system has been developed for measuring the signals with changeable pulse width in laser scattering light experiment. It has been tested with signal sources in ICF experiment. In tests, the integral nonlinearity between the integral results of the gated integrator and that of an oscilloscope is less than 1%. In the ICF experiments the maximum error between the integral results of the gated integrator and that of oscilloscope is less than 3% of the full scale range of the gated integrator. (authors)

  14. Encouraging primary care research: evaluation of a one-year, doctoral clinical epidemiology research course.

    Science.gov (United States)

    Liira, Helena; Koskela, Tuomas; Thulesius, Hans; Pitkälä, Kaisu

    2016-01-01

    Research and PhDs are relatively rare in family medicine and primary care. To promote research, regular one-year research courses for primary care professionals with a focus on clinical epidemiology were started. This study explores the academic outcomes of the first four cohorts of research courses and surveys the participants' perspectives on the research course. An electronic survey was sent to the research course participants. All peer-reviewed scientific papers published by these students were retrieved by literature searches in PubMed. Primary care in Finland. A total of 46 research course participants who had finished the research courses between 2007 and 2012. Of the 46 participants 29 were physicians, eight nurses, three dentists, four physiotherapists, and two nutritionists. By the end of 2014, 28 of the 46 participants (61%) had published 79 papers indexed in PubMed and seven students (15%) had completed a PhD. The participants stated that the course taught them critical thinking, and provided basic research knowledge, inspiration, and fruitful networks for research. A one-year, multi-professional, clinical epidemiology based research course appeared to be successful in encouraging primary care research as measured by research publications and networking. Activating teaching methods, encouraging focus on own research planning, and support from peers and tutors helped the participants to embark on research projects that resulted in PhDs for 15% of the participants. Clinical research and PhDs are rare in primary care in Finland, which has consequences for the development of the discipline and for the availability of clinical lecturers at the universities. A clinical epidemiology oriented, one-year research course increased the activity in primary care research. Focus on own research planning and learning the challenges of research with peers appeared to enhance the success of a doctoral research course. A doctoral research course encouraged networking, and

  15. [National Policy of Humanization and education of health care professionals: integrative review].

    Science.gov (United States)

    Barbosa, Guilherme Correa; Meneguim, Silmara; Lima, Silvana Andréa Molina; Moreno, Vania

    2013-01-01

    The National Policy of Humanization aims at innovations in health production, management and care with emphasis on permanent education for workers in the Unified Public Health System and training of university students in the health care field. This study aimed to know, through an integrative review of the literature, the scientific production about the National Policy of Humanization and education of health care professionals, from 2002 to 2010. Ten articles were analyzed in thematic strand through three axes: humanization and users caring, humanization and the work process, humanization and training. The articles point to the need to overcome the biological conception, valuing cultural aspects of users. The work process is marked by the devaluation of workers and by users deprived of their rights. The training of health professionals is grounded in health services where the prevailing standards are practices that hinder innovative attitudes.

  16. Fostering development of nursing practices to support integrated care when implementing integrated care pathways: what levers to use?

    Science.gov (United States)

    Longpré, Caroline; Dubois, Carl-Ardy

    2017-11-29

    Care integration has been the focus of recent health system reforms. Given their functions at all levels of the care continuum, nurses have a substantial and primordial role to play in such integration processes. The aim of this study was to identify levers and strategies that organizations can use to support the development of a nursing practice aligned with the requirements of care integration in a health and social services centre (HSSC) in Quebec. The research design was a cross-sectional descriptive qualitative study based on a single case study with nested levels of analysis. The case was a public, multi-disciplinary HSSC in a semi-urban region of Quebec. Semi-structured interviews with 37 persons (nurses, professionals, managers, administrators) allowed for data saturation and ensured theoretical representation by covering four care pathways constituting different care integration contexts. Analysis involved four steps: preparing a predetermined list of codes based on the reference framework developed by Minkman (2011); coding transcript content; developing general and summary matrices to group observations for each care pathway; and creating a general model showing the overall results for the four pathways. The organization's capacity for response with regard to developing an integrated system of services resulted in two types of complementary interventions. The first involved investing in key resources and renewing organizational structures; the second involved deploying a series of organizational and clinical-administrative processes. In resource terms, integration efforts resulted in setting up new strategic services, re-arranging physical infrastructures, and deploying new technological resources. Organizational and clinical-administrative processes to promote integration involved renewing governance, improving the flow of care pathways, fostering continuous quality improvement, developing new roles, promoting clinician collaboration, and strengthening

  17. HBV DNA Integration: Molecular Mechanisms and Clinical Implications

    Science.gov (United States)

    Tu, Thomas; Budzinska, Magdalena A.; Shackel, Nicholas A.; Urban, Stephan

    2017-01-01

    Chronic infection with the Hepatitis B Virus (HBV) is a major cause of liver-related morbidity and mortality. One peculiar observation in cells infected with HBV (or with closely‑related animal hepadnaviruses) is the presence of viral DNA integration in the host cell genome, despite this form being a replicative dead-end for the virus. The frequent finding of somatic integration of viral DNA suggests an evolutionary benefit for the virus; however, the mechanism of integration, its functions, and the clinical implications remain unknown. Here we review the current body of knowledge of HBV DNA integration, with particular focus on the molecular mechanisms and its clinical implications (including the possible consequences of replication-independent antigen expression and its possible role in hepatocellular carcinoma). HBV DNA integration is likely to influence HBV replication, persistence, and pathogenesis, and so deserves greater attention in future studies. PMID:28394272

  18. Measuring integrated care.

    Science.gov (United States)

    Strandberg-Larsen, Martin

    2011-02-01

    The positive outcomes of coordination of healthcare services are to an increasing extent becoming clear. However the complexity of the field is an inhibiting factor for vigorously designed trial studies. Conceptual clarity and a consistent theoretical frame-work are thus needed. While researchers respond to these needs, patients and providers face the multiple challenges of today's healthcare environment. Decision makers, planners and managers need evidence based policy options and information on the scope of the integrated care challenges they are facing. The US managed care organization Kaiser Permanente has been put forward as an example for European healthcare systems to follow, although the evidence base is far from conclusive. The thesis has five objectives: 1) To contribute to the understanding of the concept of integration in healthcare systems and to identify measurement methods to capture the multi-dimensional aspects of integrated healthcare delivery. 2) To assess the level of integration of the Danish healthcare system. 3) To assess the use of joint health plans as a tool for coordination between the regional and local level in the Danish healthcare system. 4) To compare the inputs and performance of the Danish healthcare system and the managed care organization Kaiser Permanente, California, US. 5) To compare primary care clinicians' perception of clinical integration in two healthcare systems: Kaiser Permanente, Northern California and the Danish healthcare system. Further to examine the associations between specific organizational factors and clinical integration within each system. The literature was systematically searched to identify methods for measurement of integrated healthcare delivery. A national cross-sectional survey was conducted among major professional stake-holders at five different levels of the Danish healthcare system. The survey data were used to allow for analysis of the level of integration achieved. Data from the survey were

  19. A framework to promote collective action within the One Health community of practice: Using participatory modelling to enable interdisciplinary, cross-sectoral and multi-level integration

    Directory of Open Access Journals (Sweden)

    Aurelie Binot

    2015-12-01

    The implementation of a One Health (OH approach in this context calls for improved integration among disciplines and improved cross-sectoral collaboration, involving stakeholders at different levels. For sure, such integration is not achieved spontaneously, implies methodological guidelines and has transaction costs. We explore pathways for implementing such collaboration in SEA context, highlighting the main challenges to be faced by researchers and other target groups involved in OH actions. On this basis, we propose a conceptual framework of OH integration. Throughout 3 components (field-based data management, professional training workshops and higher education, we suggest to develop a new culture of networking involving actors from various disciplines, sectors and levels (from the municipality to the Ministries through a participatory modelling process, fostering synergies and cooperation. This framework could stimulate long-term dialogue process, based on the combination of case studies implementation and capacity building. It aims for implementing both institutional OH dynamics (multi-stakeholders and cross-sectoral and research approaches promoting systems thinking and involving social sciences to follow-up and strengthen collective action.

  20. Evidence-based integrative medicine in clinical veterinary oncology.

    Science.gov (United States)

    Raditic, Donna M; Bartges, Joseph W

    2014-09-01

    Integrative medicine is the combined use of complementary and alternative medicine with conventional or traditional Western medicine systems. The demand for integrative veterinary medicine is growing, but evidence-based research on its efficacy is limited. In veterinary clinical oncology, such research could be translated to human medicine, because veterinary patients with spontaneous tumors are valuable translational models for human cancers. An overview of specific herbs, botanics, dietary supplements, and acupuncture evaluated in dogs, in vitro canine cells, and other relevant species both in vivo and in vitro is presented for their potential use as integrative therapies in veterinary clinical oncology. Published by Elsevier Inc.

  1. Scalable Integrated Multi-Mission Support System Simulator Release 3.0

    Science.gov (United States)

    Kim, John; Velamuri, Sarma; Casey, Taylor; Bemann, Travis

    2012-01-01

    The Scalable Integrated Multi-mission Support System (SIMSS) is a tool that performs a variety of test activities related to spacecraft simulations and ground segment checks. SIMSS is a distributed, component-based, plug-and-play client-server system useful for performing real-time monitoring and communications testing. SIMSS runs on one or more workstations and is designed to be user-configurable or to use predefined configurations for routine operations. SIMSS consists of more than 100 modules that can be configured to create, receive, process, and/or transmit data. The SIMSS/GMSEC innovation is intended to provide missions with a low-cost solution for implementing their ground systems, as well as significantly reducing a mission s integration time and risk.

  2. Simulating the Multi-Disciplinary Care Team Approach: Enhancing Student Understanding of Anatomy through an Ultrasound-Anchored Interprofessional Session

    Science.gov (United States)

    Luetmer, Marianne T.; Cloud, Beth A.; Youdas, James W.; Pawlina, Wojciech; Lachman, Nirusha

    2018-01-01

    Quality of healthcare delivery is dependent on collaboration between professional disciplines. Integrating opportunities for interprofessional learning in health science education programs prepares future clinicians to function as effective members of a multi-disciplinary care team. This study aimed to create a modified team-based learning (TBL)…

  3. Fabricating a multi-level barrier-integrated microfluidic device using grey-scale photolithography

    International Nuclear Information System (INIS)

    Nam, Yoonkwang; Kim, Minseok; Kim, Taesung

    2013-01-01

    Most polymer-replica-based microfluidic devices are mainly fabricated by using standard soft-lithography technology so that multi-level masters (MLMs) require multiple spin-coatings, mask alignments, exposures, developments, and bakings. In this paper, we describe a simple method for fabricating MLMs for planar microfluidic channels with multi-level barriers (MLBs). A single photomask is necessary for standard photolithography technology to create a polydimethylsiloxane grey-scale photomask (PGSP), which adjusts the total amount of UV absorption in a negative-tone photoresist via a wide range of dye concentrations. Since the PGSP in turn adjusts the degree of cross-linking of the photoresist, this method enables the fabrication of MLMs for an MLB-integrated microfluidic device. Since the PGSP-based soft-lithography technology provides a simple but powerful fabrication method for MLBs in a microfluidic device, we believe that the fabrication method can be widely used for micro total analysis systems that benefit from MLBs. We demonstrate an MLB-integrated microfluidic device that can separate microparticles. (paper)

  4. EasyCloneMulti: A Set of Vectors for Simultaneous and Multiple Genomic Integrations in Saccharomyces cerevisiae

    DEFF Research Database (Denmark)

    Maury, Jerome; Germann, Susanne Manuela; Jacobsen, Simo Abdessamad

    2016-01-01

    Saccharomyces cerevisiae is widely used in the biotechnology industry for production of ethanol, recombinant proteins, food ingredients and other chemicals. In order to generate highly producing and stable strains, genome integration of genes encoding metabolic pathway enzymes is the preferred...... of integrative vectors, EasyCloneMulti, that enables multiple and simultaneous integration of genes in S. cerevisiae. By creating vector backbones that combine consensus sequences that aim at targeting subsets of Ty sequences and a quickly degrading selective marker, integrations at multiple genomic loci...... and a range of expression levels were obtained, as assessed with the green fluorescent protein (GFP) reporter system. The EasyCloneMulti vector set was applied to balance the expression of the rate-controlling step in the β-alanine pathway for biosynthesis of 3-hydroxypropionic acid (3HP). The best 3HP...

  5. Professional autonomy in 21st century healthcare: nurses' accounts of clinical decision-making.

    Science.gov (United States)

    Traynor, Michael; Boland, Maggie; Buus, Niels

    2010-10-01

    Autonomy in decision-making has traditionally been described as a feature of professional work, however the work of healthcare professionals has been seen as steadily encroached upon by State and managerialist forces. Nursing has faced particular problems in establishing itself as a credible profession for reasons including history, gender and a traditional subservience to medicine. This paper reports on a focus group study of UK nurses participating in post-qualifying professional development in 2008. Three groups of nurses in different specialist areas comprised a total of 26 participants. The study uses accounts of decision-making to gain insight into contemporary professional nursing. The study also aims to explore the usefulness of a theory of professional work set out by Jamous and Peloille (1970). The analysis draws on notions of interpretive repertoires and elements of narrative analysis. We identified two interpretive repertoires: 'clinical judgement' which was used to describe the different grounds for making judgements; and 'decision-making' which was used to describe organisational circumstances influencing decision-making. Jamous and Peloille's theory proved useful for interpreting instances where the nurses collectively withdrew from the potential dangers of too extreme claims for technicality or indeterminacy in their work. However, their theory did not explain the full range of accounts of decision-making that were given. Taken at face value, the accounts from the participants depict nurses as sometimes practising in indirect ways in order to have influence in the clinical and bureaucratic setting. However, a focus on language use and in particular, interpretive repertoires, has enabled us to suggest that despite an overall picture of severely limited autonomy, nurses in the groups reproduced stories of the successful accomplishment of moral and influential action. Copyright © 2010 Elsevier Ltd. All rights reserved.

  6. Professionalism among multicultural medical students in the United Arab Emirates.

    Science.gov (United States)

    Abdulrahman, Mahera; Alsalehi, Shahd; Husain, Zahra S M; Nair, Satish C; Carrick, Frederick Robert

    2017-01-01

    Moral competencies and ethical practices of medical professionals are among the desired outcomes of academic training. Unfortunately, academic dishonesty and misconduct are reported from medical colleges across the world. This study investigates the level of academic dishonesty/misconduct among multicultural medical students. The aim of this study is to investigate the level of academic dishonesty/misconduct among multicultural medical students. Validated and customized version of Dundee Polyprofessionalism Inventory-1 detailing lapses of professionalism in undergraduate health professions education was used to determine the perceived prevalence and self-reported lapses of academic integrity in this study. This study shows that the majority (458/554, 83%) of medical students have admitted to acts of academic dishonesty mentioned in the questionnaire. Approximately 42% (231/554) of the students have given proxy for attendance and 71% of them considered this as an offense. Similarly, 12% (66/554) have copied from the record books of others, and 86% (477/554) have considered it unethical. In addition, 5% (28/554) of the students revealed forging a teacher's signature in their record or logbooks, with 16% (91/554) of them reporting that they have seen others forge signatures. This is the first multi-center, multi-cultural and multi-ethnic study involving a large number of participants that addresses academic professionalism among medical students in the Middle East. Certainly, the paucity of data limits definitive conclusions about the best approach to prevent academic misconduct in the UAE medical schools. Yet, the results of our study are anticipated not only to benefit the UAE but also to find application in the Arab world, with similar medical school programs, values, culture and tradition.

  7. [A study of work values, professional commitment, turnover intention and related factors among clinical nurses].

    Science.gov (United States)

    Wang, Kuei-Ying; Chou, Chuan-Chiang; Huang, Jui-Lan

    2010-02-01

    The high rate of turnover in nursing positions is a global problem. There have been few studies done addressing the relationship between work values and nurse turnover intention. The purpose of this study was to explore the relationship between work values, professional commitment and turnover intention among clinical nurses. A cross-sectional survey was conducted between February 1st to March 10th, 2008 on a convenience sample of nurses, all of whom had at least a half year of work experience at one of four teaching hospitals in Taiwan. A total of 289 valid responses were received, with a response rate of 96.3%. Major findings included: (1) Nurses who were older, had more years of school, had worked more years, held specific job duties, earned a higher salary, held Buddhist beliefs, or were married with two or more children presented higher work values and professional commitment and lower turnover intention; (2) As a group, total work values and professional commitment scores corresponded negatively with turnover intention scores; (3) Significant factors affecting turnover intent in clinical nurses included professional commitment, institution characteristics, Buddhist beliefs and salary. These four variables accounted for 52.2% of the variation in turnover intention. This study indicated that nurses with higher work values and professional commitment tend to exhibit less turnover intention. It is highly recommended to develop strategies to bolster the teaching of altruistic values and professional commitment in nursing education in order to reduce turnover intent. Also, further studies on the influence of religious beliefs and organizational attributes on nurse turnover intentions are also suggested.

  8. Identifying emotional intelligence skills of Turkish clinical nurses according to sociodemographic and professional variables.

    Science.gov (United States)

    Kahraman, Nilgün; Hiçdurmaz, Duygu

    2016-04-01

    This study aimed to identify the emotional intelligence skills of Turkish clinical nurses according to sociodemographic and professional variables. Emotional intelligence is "the ability of a person to comprehend self-emotions, to show empathy towards the feelings of others, and to control self-emotions in a way that enriches life." Nurses with a higher emotional intelligence level offer more efficient and professional care, and they accomplish more in their social and professional lives. We designed a descriptive cross-sectional study. The Introductory Information Form and the Bar-On emotional intelligence Inventory were used to collect data between 20th June and 20th August 2012. The study was conducted with 312 nurses from 37 hospitals located within the borders of the metropolitan municipality in Ankara. There were no significant differences between emotional intelligence scores of the nurses according to demographic variables such as age, gender, marital status, having children. Thus, sociodemographic factors did not appear to be key factors, but some professional variables did. Higher total emotional intelligence scores were observed in those who had 10 years or longer experience, who found oneself successful in professional life, who stated that emotional intelligence is an improvable skill and who previously received self-improvement training. Interpersonal skills were higher in those with a graduate degree and in nurses working in polyclinics and paediatric units. These findings indicate which groups require improvement in emotional intelligence skills and which skills need improvement. Additionally, these results provide knowledge and create awareness about emotional intelligence skills of nurses and the distribution of these skills according to sociodemographic and professional variables. Implementation of emotional intelligence improvement programmes targeting the determined clinical nursing groups by nursing administrations can help the increase in

  9. Opinions of maternity care professionals and other stakeholders about integration of maternity care: a qualitative study in the Netherlands.

    NARCIS (Netherlands)

    Perdok, H.; Jans, S.; Verhoeven, C.; Henneman, L.; Wiegers, T.; Mol, B.W.; Schellevis, F.; Jonge, A. de

    2016-01-01

    Background: This study aims to give insight into the opinions of maternity care professionals and other stakeholders on the integration of midwife-led care and obstetrician-led care and on the facilitating and inhibiting factors for integrating maternity care. Methods: Qualitative study using

  10. OM4 bend insensitive multi-mode fibers’ usefulness for MCM integration

    International Nuclear Information System (INIS)

    Guzowski, Bartłomiej; Lisik, Zbigniew; Tosik, Grzegorz; Ciupa, Emilia

    2012-01-01

    Highlights: ► The influence of high temperature exposure on OM4 fibers’ mechanical properties. ► Researching OM4 class fibers for use in innovative Optical Multi Chip Module. ► The influence of bending at a very small radius, up to 2 mm, on MM fibers. - Abstract: For future generations of electronic systems, a severe bottleneck is expected on the interconnection level and the use of optical interconnection is considered as one of the most promising solutions in this matter. Recent progress in fiber development resulted in new generation of optical fibers that are bend insensitive. This makes them ideal for Multi Chip Module (MCM) application. This paper focuses on OM4 bend insensitive multi-mode fibers’ usefulness for MCM integration, particularly the investigation of MM fiber loss is presented, which is influenced by bend diameter and the fiber's mechanical performance under influence of high temperature (400 °C–1000 °C adequate to MCM production process).

  11. Sustainability of professionals' adherence to clinical practice guidelines in medical care: a systematic review.

    Science.gov (United States)

    Ament, Stephanie M C; de Groot, Jeanny J A; Maessen, José M C; Dirksen, Carmen D; van der Weijden, Trudy; Kleijnen, Jos

    2015-12-29

    To evaluate (1) the state of the art in sustainability research and (2) the outcomes of professionals' adherence to guideline recommendations in medical practice. Systematic review. Searches were conducted until August 2015 in MEDLINE, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) and the Guidelines International Network (GIN) library. A snowball strategy, in which reference sections of other reviews and of included papers were searched, was used to identify additional papers. Studies needed to be focused on sustainability and on professionals' adherence to clinical practice guidelines in medical care. Studies had to include at least 2 measurements: 1 before (PRE) or immediately after implementation (EARLY POST) and 1 measurement longer than 1 year after active implementation (LATE POST). The search retrieved 4219 items, of which 14 studies met the inclusion criteria, involving 18 sustainability evaluations. The mean timeframe between the end of active implementation and the sustainability evaluation was 2.6 years (minimum 1.5-maximum 7.0). The studies were heterogeneous with respect to their methodology. Sustainability was considered to be successful if performance in terms of professionals' adherence was fully maintained in the late postimplementation phase. Long-term sustainability of professionals' adherence was reported in 7 out of 18 evaluations, adherence was not sustained in 6 evaluations, 4 evaluations showed mixed sustainability results and in 1 evaluation it was unclear whether the professional adherence was sustained. (2) Professionals' adherence to a clinical practice guideline in medical care decreased after more than 1 year after implementation in about half of the cases. (1) Owing to the limited number of studies, the absence of a uniform definition, the high risk of bias, and the mixed results of studies, no firm conclusion about the sustainability of professionals' adherence to guidelines in medical practice can be drawn

  12. Multi-parameter Analysis and Inversion for Anisotropic Media Using the Scattering Integral Method

    KAUST Repository

    Djebbi, Ramzi

    2017-01-01

    the model. I study the prospect of applying a scattering integral approach for multi-parameter inversion for a transversely isotropic model with a vertical axis of symmetry. I mainly analyze the sensitivity kernels to understand the sensitivity of seismic

  13. Conversation as Academic Practice: Tutors' Strategies in Integrating Student Learning in a Professional Training Degree Programme

    Directory of Open Access Journals (Sweden)

    Matt Bowden

    2013-04-01

    Full Text Available Tutors are generally considered to be an additional resource in teaching and learning, as a means of augmenting that of the lecturer. This article explores tutors as academic staff with responsibilities for developing practice competencies and integrating student learning in a social care professional training degree programme. The research is small-scale, based upon data from a purposive sample of five interviews; and upon insider-participant observation notes and reflections in one single setting. The author deployed a situated ethnographic methodology alongside a frame analytic approach. The research found that in their academic practice, tutors reveal how their student contact is oriented to developing a reflective practitioner and they discuss how programme inputs impact on the student’s professional self. Simultaneously, tutors seek to create cross programme integration through finding overlaps with academic programme strands.

  14. Nurses' clinical reasoning practices that support safe medication administration: An integrative review of the literature.

    Science.gov (United States)

    Rohde, Emily; Domm, Elizabeth

    2018-02-01

    To review the current literature about nurses' clinical reasoning practices that support safe medication administration. The literature about medication administration frequently focuses on avoiding medication errors. Nurses' clinical reasoning used during medication administration to maintain medication safety receives less attention in the literature. As healthcare professionals, nurses work closely with patients, assessing and intervening to promote mediation safety prior to, during and after medication administration. They also provide discharge teaching about using medication safely. Nurses' clinical reasoning and practices that support medication safety are often invisible when the focus is medication errors avoidance. An integrative literature review was guided by Whittemore and Knafl's (Journal of Advanced Nursing, 5, 2005 and 546) five-stage review of the 11 articles that met review criteria. This review is modelled after Gaffney et al.'s (Journal of Clinical Nursing, 25, 2016 and 906) integrative review on medical error recovery. Health databases were accessed and systematically searched for research reporting nurses' clinical reasoning practices that supported safe medication administration. The level and quality of evidence of the included research articles were assessed using The Johns Hopkins Nursing Evidence-Based Practice Rating Scale©. Nurses have a central role in safe medication administration, including but not limited to risk awareness about the potential for medication errors. Nurses assess patients and their medication and use knowledge and clinical reasoning to administer medication safely. Results indicated nurses' use of clinical reasoning to maintain safe medication administration was inadequately articulated in 10 of 11 studies reviewed. Nurses are primarily responsible for safe medication administration. Nurses draw from their foundational knowledge of patient conditions and organisational processes and use clinical reasoning that

  15. Analog integrated circuit for micro-gyro interface realized by multi-chip service in Japan; Multi chip service ni yoru micro gyro interface shuseki kairo no sekkei to shisaku

    Energy Technology Data Exchange (ETDEWEB)

    Maenaka, K.; Fujita, T.; Okamoto, K.; Maeda, M. [Himeji Institute of Technology, Hyogo (Japan)

    1998-10-01

    This paper deals with an analog integrated circuit for micro-machined gyroscopes with capacitive output. The Integrated circuit was fabricated as a part of the first project from the `Micromachining Multi-Chip Service Cooperative Re-search Committee` organized by The Institute of Electrical Engineers Japan. This multi-chip service project offers a master slice chip with an equivalent of 9 blocks of operational amplifier circuits. Our integrated circuit includes a modulator, demodulator and synchronous rectifier for detecting small changes in the capacitance of a silicon gyroscope. In the paper, the experimental results of fabricated samples will be described. 13 refs., 15 figs.

  16. Wavefront correction and high-resolution in vivo OCT imaging with an objective integrated multi-actuator adaptive lens.

    Science.gov (United States)

    Bonora, Stefano; Jian, Yifan; Zhang, Pengfei; Zam, Azhar; Pugh, Edward N; Zawadzki, Robert J; Sarunic, Marinko V

    2015-08-24

    Adaptive optics is rapidly transforming microscopy and high-resolution ophthalmic imaging. The adaptive elements commonly used to control optical wavefronts are liquid crystal spatial light modulators and deformable mirrors. We introduce a novel Multi-actuator Adaptive Lens that can correct aberrations to high order, and which has the potential to increase the spread of adaptive optics to many new applications by simplifying its integration with existing systems. Our method combines an adaptive lens with an imaged-based optimization control that allows the correction of images to the diffraction limit, and provides a reduction of hardware complexity with respect to existing state-of-the-art adaptive optics systems. The Multi-actuator Adaptive Lens design that we present can correct wavefront aberrations up to the 4th order of the Zernike polynomial characterization. The performance of the Multi-actuator Adaptive Lens is demonstrated in a wide field microscope, using a Shack-Hartmann wavefront sensor for closed loop control. The Multi-actuator Adaptive Lens and image-based wavefront-sensorless control were also integrated into the objective of a Fourier Domain Optical Coherence Tomography system for in vivo imaging of mouse retinal structures. The experimental results demonstrate that the insertion of the Multi-actuator Objective Lens can generate arbitrary wavefronts to correct aberrations down to the diffraction limit, and can be easily integrated into optical systems to improve the quality of aberrated images.

  17. Perspectives on Clinical Informatics: Integrating Large-Scale Clinical, Genomic, and Health Information for Clinical Care

    Directory of Open Access Journals (Sweden)

    In Young Choi

    2013-12-01

    Full Text Available The advances in electronic medical records (EMRs and bioinformatics (BI represent two significant trends in healthcare. The widespread adoption of EMR systems and the completion of the Human Genome Project developed the technologies for data acquisition, analysis, and visualization in two different domains. The massive amount of data from both clinical and biology domains is expected to provide personalized, preventive, and predictive healthcare services in the near future. The integrated use of EMR and BI data needs to consider four key informatics areas: data modeling, analytics, standardization, and privacy. Bioclinical data warehouses integrating heterogeneous patient-related clinical or omics data should be considered. The representative standardization effort by the Clinical Bioinformatics Ontology (CBO aims to provide uniquely identified concepts to include molecular pathology terminologies. Since individual genome data are easily used to predict current and future health status, different safeguards to ensure confidentiality should be considered. In this paper, we focused on the informatics aspects of integrating the EMR community and BI community by identifying opportunities, challenges, and approaches to provide the best possible care service for our patients and the population.

  18. Toward generally accepted forensic assessment practices among clinical neuropsychologists: a survey of professional practice and common test use.

    Science.gov (United States)

    LaDuke, Casey; Barr, William; Brodale, Donald L; Rabin, Laura A

    2018-01-01

    This study investigated professional practice and common test use among clinical neuropsychologists engaging in forensic assessment.  Doctorate-level psychologists active in the practice of neuropsychology and on the INS and NAN membership listings (n = 502) were surveyed about their demographics, professional practice, and common test use. Participants who reported engaging in forensic practice (n = 255) were further surveyed about their forensic practice. Forensic participants were more likely to be male and Caucasian, and reported higher ages, more years of professional experience, and a higher prevalence of board certification. While characteristics of their professional and forensic practice varied, forensic participants reported spending most of their professional time conducting neuropsychological assessments with adult clients in a private or group practice setting, focusing on civil referrals and civil legal questions involving older adult issues, developmental issues, head injury, and psychiatric issues. Common test use across neuropsychological assessment domains is presented for board-certified forensic participants (n = 77). An examination of these results reveals that the current pattern of test use is similar to the results of a more general survey of neuropsychological test use.  The findings provide insight into the practice of forensic neuropsychological assessment, and further establish the admissibility of neuropsychological evidence in the United States legal system. Results will be useful for clinical neuropsychologists, field leaders, and legal professionals hoping to gain insight into the role of clinical neuropsychology in civil and criminal legal decision-making.

  19. Multi-regional clinical trials and global drug development

    Directory of Open Access Journals (Sweden)

    Premnath Shenoy

    2016-01-01

    Full Text Available Drug development has been globalized, and multi-regional clinical trial (MRCT for regulatory submission has widely been conducted by many discovery based global pharmaceutical companies with the objective of reducing the time lag of launch in key markets and improve patient access to new and innovative treatments. Sponsors are facing several challenges while conducting multiregional clinical trials. Challenges under the heads statistics, clinical, regulatory operational, and ethics have been discussed. Regulators in different countries such as USA, EU-Japan, and China have issued guidance documents in respect of MRCT's. Lack of harmonization in the design and planning of MRCT is perceived to create a difficult situation to sponsors adversely affecting progressing MRCT in more and more discoveries. International conference on hormonisation (ICH has initiated the process for having a harmonized guidance document on MRCT. This document is likely to be issued in early 2017.

  20. A novel mentorship programme for residents integrating academic development, clinical teaching and graduate medical education assessment.

    Science.gov (United States)

    Bhatia, Kriti; Takayesu, James Kimo; Nadel, Eric S

    2016-02-01

    Mentorship fosters career development and growth. During residency training, mentorship should support clinical development along with intellectual and academic interests. Reported resident mentoring programmes do not typically include clinical components. We designed a programme that combines academic development with clinical feedback and assessment in a four-year emergency medicine residency programme. Incoming interns were assigned an advisor. At the conclusion of the intern year, residents actively participated in selecting a mentor for the duration of residency. The programme consisted of quarterly meetings, direct clinical observation and specific competency assessment, assistance with lecture preparation, real-time feedback on presentations, simulation coaching sessions, and discussions related to career development. Faculty participation was recognized as a valuable component of the annual review process. Residents were surveyed about the overall programme and individual components. Over 88 % of the respondents said that the programme was valuable and should be continued. Senior residents most valued the quarterly meetings and presentation help and feedback. Junior residents strongly valued the clinical observation and simulation sessions. A comprehensive mentorship programme integrating clinical, professional and academic development provides residents individualized feedback and coaching and is valued by trainees. Individualized assessment of clinical competencies can be conducted through such a programme.

  1. Multi-Year Professional Development Grounded in Educative Curriculum Focused on Integrating Technology with Reformed Science Teaching Principles

    Science.gov (United States)

    Longhurst, Max L.; Coster, Daniel C.; Wolf, Paul G.; Duffy, Aaron M.; Lee, Hyunju; Campbell, Todd

    2016-01-01

    Visions of science teaching and learning in the newest U.S. standards documents are dramatically different than those found in most classrooms. This research addresses these differences through closely examining one professional development (PD) project that connects teacher learning and teacher practice with student learning/achievement. This…

  2. Economic analysis of centralized vs. decentralized electronic data capture in multi-center clinical studies.

    Science.gov (United States)

    Walden, Anita; Nahm, Meredith; Barnett, M Edwina; Conde, Jose G; Dent, Andrew; Fadiel, Ahmed; Perry, Theresa; Tolk, Chris; Tcheng, James E; Eisenstein, Eric L

    2011-01-01

    New data management models are emerging in multi-center clinical studies. We evaluated the incremental costs associated with decentralized vs. centralized models. We developed clinical research network economic models to evaluate three data management models: centralized, decentralized with local software, and decentralized with shared database. Descriptive information from three clinical research studies served as inputs for these models. The primary outcome was total data management costs. Secondary outcomes included: data management costs for sites, local data centers, and central coordinating centers. Both decentralized models were more costly than the centralized model for each clinical research study: the decentralized with local software model was the most expensive. Decreasing the number of local data centers and case book pages reduced cost differentials between models. Decentralized vs. centralized data management in multi-center clinical research studies is associated with increases in data management costs.

  3. Two hierarchies of multi-component Kaup-Newell equations and theirs integrable couplings

    International Nuclear Information System (INIS)

    Zhu Fubo; Ji Jie; Zhang Jianbin

    2008-01-01

    Two hierarchies of multi-component Kaup-Newell equations are derived from an arbitrary order matrix spectral problem, including positive non-isospectral Kaup-Newell hierarchy and negative non-isospectral Kaup-Newell hierarchy. Moreover, new integrable couplings of the resulting Kaup-Newell soliton hierarchies are constructed by enlarging the associated matrix spectral problem

  4. The evolution and development of an instrument to measure essential professional nursing practices.

    Science.gov (United States)

    Kramer, Marlene; Brewer, Barbara B; Halfer, Diana; Hnatiuk, Cynthia Nowicki; MacPhee, Maura; Schmalenberg, Claudia

    2014-11-01

    Nursing continues to evolve from a task-oriented occupation to a holistic professional practice. Increased professionalism requires accurate measurement of care processes and practice. Nursing studies often omit measurement of the relationship between structures in the work environment and processes of care or between processes of care and patient outcomes. Process measurement is integral to understanding and improving nursing practice. This article describes the development of an updated Essentials of Magnetism process measurement instrument for clinical nurses (CNs) practicing on inpatient units in hospitals. It has been renamed Essential Professional Nursing Practices: CN.

  5. Negotiating competency, professionalism and risk: the integration of complementary and alternative medicine by nurses and midwives in NHS hospitals.

    Science.gov (United States)

    Cant, Sarah; Watts, Peter; Ruston, Annmarie

    2011-02-01

    This qualitative interview study examined the use of complementary and alternative medicine (CAM) by nurses and midwives in NHS hospital settings in 2008 in the UK. It showed that the groundswell of interest in CAM in the 1990s had diminished by this time due to changes to policy and funding, and increasingly stringent clinical governance. Nevertheless, CAM provided an opportunity for committed and self-motivated practitioners to extend their therapeutic repertoire and develop affective dimensions of practice. However, the integration of CAM did not afford the autonomy, status and material gains traditionally associated with a collective professional project. In practice, occupational strategies were individualistic, and grounded in the assertion of competency through expressions of professionalism rather than the credentialism which underpins classic professionalisation. Central to these strategies was CAM related risk, which became a means by which to claim occupational space. However, the extent to which the adoption of CAM enhanced the nurses' and midwives' roles was limited by traditional medical authority; the uncertain status of CAM knowledge; and the absence of collective strategies - which together often left practitioners in a position of vulnerability. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. A Conceptual Framework for Clinical Education in Athletic Training

    Science.gov (United States)

    Radtke, Sarah

    2008-01-01

    Objective: To develop a model for clinical education in athletic training education based on integration of various allied health professional clinical education models. Background: Clinical education is a critical component of allied health education programs. It allows for the transfer of knowledge and skills from classroom to practical…

  7. Consultant paediatric outreach clinics--a practical step in integration.

    Science.gov (United States)

    Spencer, N J

    1993-04-01

    Ten years' experience of paediatric outreach clinics is reviewed and evaluated. The advantages and disadvantages of paediatric outreach and its possible place in the new era of contracting and more developed community paediatric services are discussed. It is concluded that paediatric outreach increases parental and professional choice and access to paediatric consultant services, increases service flexibility, reduces unnecessary hospital visits, and enables more rational and relevant clinical decision making. Outreach is particularly relevant in areas of deprivation where paediatric needs are greatest.

  8. The investigation of STEM Self-Efficacy and Professional Commitment to Engineering among female high school students

    Directory of Open Access Journals (Sweden)

    Yi-hui Liu

    2014-06-01

    Full Text Available This study employed social cognitive theory and social cognitive career theory (SCCT as foundations to explore the influence of high school students' beliefs about female gender roles and female engineer role models on science, technology, engineering, and mathematics (STEM self-efficacy and professional commitment to engineering. A total of 88 students from a national girls' high school participated in STEM project-based learning. A survey questionnaire named The STEM Self-efficacy and Professional Commitment to Engineering Questionnaire, developed by the researchers, was administered to collect data, and a structured equation model was employed to confirm the multi-theoretical model developed in this study. The results of this study show that enhancing the gender role beliefs and engineer role models of female students may increase their STEM self-efficacy and professional commitment to engineering. In other words, the female high school students' professional commitment to engineering model can explain students' intentions for future engineering careers. Thus, this study suggests integrating STEM project-based learning into the curricula of various schools and integrating female engineer role models into STEM project-based learning activities for female students, which can enhance female high school students' STEM self-efficacy and professional commitment to engineering.

  9. Multi-agents Based Modelling for Distribution Network Operation with Electric Vehicle Integration

    DEFF Research Database (Denmark)

    Hu, Junjie; Morais, Hugo; Zong, Yi

    2014-01-01

    Electric vehicles (EV) can become integral part of a smart grid because instead of just consuming power they are capable of providing valuable services to power systems. To integrate EVs smoothly into the power systems, a multi-agents system (MAS) with hierarchical organization structure...... and its role is to manage the distribution network safely by avoiding grid congestions and using congestion prices to coordinate the energy schedule of VPPs. VPP agents belong to the middle level and their roles are to manage the charge periods of the EVs. EV agents sit in the bottom level...

  10. Transition From Clinical to Educator Roles in Nursing: An Integrative Review.

    Science.gov (United States)

    Fritz, Elizabeth

    This review identified barriers to and facilitators of nurses' transition from clinical positions into nursing professional development and other nurse educator roles. The author conducted literature searches using multiple databases. Twenty-one articles met search criteria, representing a variety of practice settings. The findings, both barriers and facilitators, were remarkably consistent across practice settings. Four practice recommendations were drawn from the literature to promote nurses' successful transition to nursing professional development roles.

  11. Using theories of learning in workplaces to enhance physiotherapy clinical education.

    Science.gov (United States)

    Patton, Narelle; Higgs, Joy; Smith, Megan

    2013-10-01

    Clinical education has long been accepted as integral to the education of physiotherapy students and their preparation for professional practice. The clinical environment, through practice immersion, situates students in a powerful learning context and plays a critical role in students' construction of professional knowledge. Despite this acknowledged centrality of practice and clinical environments to the students' experiential construction of professional knowledge, there has been limited exploration of learning theories underpinning clinical education in the literature. In this paper, we explore a selection of learning theories underpinning physiotherapy clinical education with a view to providing clinical educators with a firm foundation on which to base wise educational practices and potentially enhance physiotherapy students' clinical learning experiences. This exploration has drawn from leading thinkers in the field of education over the past century.

  12. The Federal Trade Commission, clinical integration, and the organization of physician practice.

    Science.gov (United States)

    Casalino, Lawrence P

    2006-06-01

    This article examines Federal Trade Commission (FTC) policy--in particular, the agency's controversial 1996 statements on clinical integration--toward joint negotiations for nonrisk contracts with health plans by physicians organized into independent practice associations (IPAs) and (with hospitals) into physician-hospital organizations (PHOs). The article concludes that the policy is consistent with anti-trust principles, consistent with current thinking on the use of organized processes to improve medical care quality, specific enough to provide guidance to physicians wanting to integrate clinically, and general enough to encourage ongoing innovations in physician organization. The FTC should consider stronger sanctions for IPAs and PHOs whose clinical integration is nothing more than a sham intended to provide cover for joint negotiations, should give the benefit of the doubt to organizations whose clinical integration appears to be reasonably consonant with the statements, and should clarify several ambiguities in the statements. Health plans should facilitate IPA and PHO efforts to improve care by rewarding quality and efficiency and by providing clinically integrated organizations with claims information on individual patients. Though creating clinically integrated organizations is difficult and expensive, physicians should recognize that clinical integration can help them both to gain some negotiating leverage with health plans and to improve the quality of care for their patients.

  13. Multi-agent based modeling for electric vehicle integration in a distribution network operation

    DEFF Research Database (Denmark)

    Hu, Junjie; Morais, Hugo; Lind, Morten

    2016-01-01

    The purpose of this paper is to present a multi-agent based modeling technology for simulating and operating a hierarchical energy management of a power distribution system with focus on EVs integration. The proposed multi-agent system consists of four types of agents: i) Distribution system...... operator (DSO) technical agent and ii) DSO market agents that both belong to the top layer of the hierarchy and their roles are to manage the distribution network by avoiding grid congestions and using congestion prices to coordinate the energy scheduled; iii) Electric vehicle virtual power plant agents...

  14. Multi-Sensor Integration to Map Odor Distribution for the Detection of Chemical Sources

    Directory of Open Access Journals (Sweden)

    Xiang Gao

    2016-07-01

    Full Text Available This paper addresses the problem of mapping odor distribution derived from a chemical source using multi-sensor integration and reasoning system design. Odor localization is the problem of finding the source of an odor or other volatile chemical. Most localization methods require a mobile vehicle to follow an odor plume along its entire path, which is time consuming and may be especially difficult in a cluttered environment. To solve both of the above challenges, this paper proposes a novel algorithm that combines data from odor and anemometer sensors, and combine sensors’ data at different positions. Initially, a multi-sensor integration method, together with the path of airflow was used to map the pattern of odor particle movement. Then, more sensors are introduced at specific regions to determine the probable location of the odor source. Finally, the results of odor source location simulation and a real experiment are presented.

  15. How Teachers Integrate a Math Computer Game: Professional Development Use, Teaching Practices, and Student Achievement

    Science.gov (United States)

    Callaghan, M. N.; Long, J. J.; van Es, E. A.; Reich, S. M.; Rutherford, T.

    2018-01-01

    As more attention is placed on designing digital educational games to align with schools' academic aims (e.g., Common Core), questions arise regarding how professional development (PD) may support teachers' using games for instruction and how such integration might impact students' achievement. This study seeks to (a) understand how teachers use…

  16. Acceptability of the Predicting Abusive Head Trauma (PredAHT) clinical prediction tool: A qualitative study with child protection professionals.

    Science.gov (United States)

    Cowley, Laura E; Maguire, Sabine; Farewell, Daniel M; Quinn-Scoggins, Harriet D; Flynn, Matthew O; Kemp, Alison M

    2018-05-09

    The validated Predicting Abusive Head Trauma (PredAHT) tool estimates the probability of abusive head trauma (AHT) based on combinations of six clinical features: head/neck bruising; apnea; seizures; rib/long-bone fractures; retinal hemorrhages. We aimed to determine the acceptability of PredAHT to child protection professionals. We conducted qualitative semi-structured interviews with 56 participants: clinicians (25), child protection social workers (10), legal practitioners (9, including 4 judges), police officers (8), and pathologists (4), purposively sampled across southwest United Kingdom. Interviews were recorded, transcribed and imported into NVivo for thematic analysis (38% double-coded). We explored participants' evaluations of PredAHT, their opinions about the optimal way to present the calculated probabilities, and their interpretation of probabilities in the context of suspected AHT. Clinicians, child protection social workers and police thought PredAHT would be beneficial as an objective adjunct to their professional judgment, to give them greater confidence in their decisions. Lawyers and pathologists appreciated its value for prompting multidisciplinary investigations, but were uncertain of its usefulness in court. Perceived disadvantages included: possible over-reliance and false reassurance from a low score. Interpretations regarding which percentages equate to 'low', 'medium' or 'high' likelihood of AHT varied; participants preferred a precise % probability over these general terms. Participants would use PredAHT with provisos: if they received multi-agency training to define accepted risk thresholds for consistent interpretation; with knowledge of its development; if it was accepted by colleagues. PredAHT may therefore increase professionals' confidence in their decision-making when investigating suspected AHT, but may be of less value in court. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. Conservative multi-implicit integral deferred correction methods with adaptive mesh refinement

    International Nuclear Information System (INIS)

    Layton, A.T.

    2004-01-01

    In most models of reacting gas dynamics, the characteristic time scales of chemical reactions are much shorter than the hydrodynamic and diffusive time scales, rendering the reaction part of the model equations stiff. Moreover, nonlinear forcings may introduce into the solutions sharp gradients or shocks, the robust behavior and correct propagation of which require the use of specialized spatial discretization procedures. This study presents high-order conservative methods for the temporal integration of model equations of reacting flows. By means of a method of lines discretization on the flux difference form of the equations, these methods compute approximations to the cell-averaged or finite-volume solution. The temporal discretization is based on a multi-implicit generalization of integral deferred correction methods. The advection term is integrated explicitly, and the diffusion and reaction terms are treated implicitly but independently, with the splitting errors present in traditional operator splitting methods reduced via the integral deferred correction procedure. To reduce computational cost, time steps used to integrate processes with widely-differing time scales may differ in size. (author)

  18. MUSE: Challenges to integrate the Multi-Disciplinary field of BB access in one project

    NARCIS (Netherlands)

    Fatome, J.; Pitois, S.; Kamagate, A.; Maillotte, H.; Massoubre., D.; González-Herráez, G.-H.; Smedt, A. de; Brink, R. van den

    2006-01-01

    The present paper discusses the managerial challenges of the MUSE integrated project on multi service broadband access. It addresses different aspects such as matrix organisation, project office, consensus process, standardisation, dissemination, and quality control.

  19. An Interdisciplinary Approach to Lesbian, Gay, Bisexual, and Transgender Clinical Competence, Professional Training, and Ethical Care: Introduction to the Special Issue.

    Science.gov (United States)

    Bidell, Markus P; Stepleman, Lara M

    2017-01-01

    There are exigent reasons to foster lesbian, gay, bisexual, and transgender (LGBT) competence, training, and ethical care for health professionals within an interdisciplinary paradigm. LGBT individuals experience serious health and psychosocial disparities; moreover, these inequalities can be amplified when other aspects of diversity such as race, ethnicity, age, gender, religion, disability, and socioeconomic status intersect with sexual orientation and gender identity (Institute of Medicine [IOM], 2011). While the origins of LGBT health and psychosocial disparities are manifold, deficiencies in professional training, ethical care, and clinical competence are underlying contributors (IOM, 2011). In addition, LGBT clinical competency advancements are often siloed within the various health care disciplines-thus advances by one group of health professionals often have limited impact for those practicing in different health and human service fields. This special issue explores LGBT clinical competence, professional training, and ethical care within an interdisciplinary context and, to our knowledge, represents the first attempt to address LGBT clinical competence from a multidisciplinary health care perspective.

  20. A survey of informatics platforms that enable distributed comparative effectiveness research using multi-institutional heterogeneous clinical data

    Science.gov (United States)

    Sittig, Dean F.; Hazlehurst, Brian L.; Brown, Jeffrey; Murphy, Shawn; Rosenman, Marc; Tarczy-Hornoch, Peter; Wilcox, Adam B.

    2012-01-01

    Comparative Effectiveness Research (CER) has the potential to transform the current healthcare delivery system by identifying the most effective medical and surgical treatments, diagnostic tests, disease prevention methods and ways to deliver care for specific clinical conditions. To be successful, such research requires the identification, capture, aggregation, integration, and analysis of disparate data sources held by different institutions with diverse representations of the relevant clinical events. In an effort to address these diverse demands, there have been multiple new designs and implementations of informatics platforms that provide access to electronic clinical data and the governance infrastructure required for inter-institutional CER. The goal of this manuscript is to help investigators understand why these informatics platforms are required and to compare and contrast six, large-scale, recently funded, CER-focused informatics platform development efforts. We utilized an 8-dimension, socio-technical model of health information technology use to help guide our work. We identified six generic steps that are necessary in any distributed, multi-institutional CER project: data identification, extraction, modeling, aggregation, analysis, and dissemination. We expect that over the next several years these projects will provide answers to many important, and heretofore unanswerable, clinical research questions. PMID:22692259

  1. A survey of informatics platforms that enable distributed comparative effectiveness research using multi-institutional heterogenous clinical data.

    Science.gov (United States)

    Sittig, Dean F; Hazlehurst, Brian L; Brown, Jeffrey; Murphy, Shawn; Rosenman, Marc; Tarczy-Hornoch, Peter; Wilcox, Adam B

    2012-07-01

    Comparative effectiveness research (CER) has the potential to transform the current health care delivery system by identifying the most effective medical and surgical treatments, diagnostic tests, disease prevention methods, and ways to deliver care for specific clinical conditions. To be successful, such research requires the identification, capture, aggregation, integration, and analysis of disparate data sources held by different institutions with diverse representations of the relevant clinical events. In an effort to address these diverse demands, there have been multiple new designs and implementations of informatics platforms that provide access to electronic clinical data and the governance infrastructure required for interinstitutional CER. The goal of this manuscript is to help investigators understand why these informatics platforms are required and to compare and contrast 6 large-scale, recently funded, CER-focused informatics platform development efforts. We utilized an 8-dimension, sociotechnical model of health information technology to help guide our work. We identified 6 generic steps that are necessary in any distributed, multi-institutional CER project: data identification, extraction, modeling, aggregation, analysis, and dissemination. We expect that over the next several years these projects will provide answers to many important, and heretofore unanswerable, clinical research questions.

  2. Competency Maps: an Effective Model to Integrate Professional Competencies Across a STEM Curriculum

    Science.gov (United States)

    Sánchez Carracedo, Fermín; Soler, Antonia; Martín, Carme; López, David; Ageno, Alicia; Cabré, Jose; Garcia, Jordi; Aranda, Joan; Gibert, Karina

    2018-05-01

    Curricula designed in the context of the European Higher Education Area need to be based on both domain-specific and professional competencies. Whereas universities have had extensive experience in developing students' domain-specific competencies, fostering professional competencies poses a new challenge we need to face. This paper presents a model to globally develop professional competencies in a STEM (science, technology, engineering, and mathematics) degree program, and assesses the results of its implementation after 4 years. The model is based on the use of competency maps, in which each competency is defined in terms of competency units. Each competency unit is described by a set of expected learning outcomes at three domain levels. This model allows careful analysis, revision, and iteration for an effective integration of professional competencies in domain-specific subjects. A global competency map is also designed, including all the professional competency learning outcomes to be achieved throughout the degree. This map becomes a useful tool for curriculum designers and coordinators. The results were obtained from four sources: (1) students' grades (classes graduated from 2013 to 2016, the first 4 years of the new Bachelor's Degree in Informatics Engineering at the Barcelona School of Informatics); (2) students' surveys (answered by students when they finished the degree); (3) the government employment survey, where former students evaluate their satisfaction of the received training in the light of their work experience; and (4) the Everis Foundation University-Enterprise Ranking, answered by over 2000 employers evaluating their satisfaction regarding their employees' university training, where the Barcelona School of Informatics scores first in the national ranking. The results show that competency maps are a good tool for developing professional competencies in a STEM degree.

  3. Learning clinical communication skills: outcomes of a program for professional practitioners.

    Science.gov (United States)

    Carvalho, Irene P; Pais, Vanessa G; Almeida, Susana S; Ribeiro-Silva, Raquel; Figueiredo-Braga, Margarida; Teles, Ana; Castro-Vale, Ivone; Mota-Cardoso, Rui

    2011-07-01

    To assess the effects of a communication skills program on professional practitioners' performance and self-confidence in clinical interviewing. Twenty-five health professionals took 3 months of basic communication skills followed by 3 months of advanced communication skills. An additional quarter dealt with self-awareness and communication in special situations. Participants' performances were evaluated in clinical interviews with standardized patients before, during and after the program by external observers and standardized patients, using standardized instruments. Participants assessed their own confidence in their communication skills before and after the program. Data were analysed using GLM repeated-measures procedures in SPSS. Basic communication skills and self-confidence improved throughout the 6 months; competencies declined but self-confidence continued to increase 4 months later. Compared with taking no course, differences were statistically significant after the 6 months (external observers only) and 4 months later (external observers and participants). The program effectively improved communication skills, although significantly only when assessed by external observers. Four months later, effects were significant in communication skills (external observers), despite the decline and in self-confidence. While periodical enrollment in programs for the practice of communication skills may help maintain performance, more knowledge on communication and self-awareness may enhance self-confidence. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  4. Perception of Dental Professionals towards Biostatistics.

    Science.gov (United States)

    Batra, Manu; Gupta, Mudit; Dany, Subha Soumya; Rajput, Prashant

    2014-01-01

    Biostatistics is becoming an integral part of dental sciences. Awareness regarding the subject is not thoroughly assessed in the field of dentistry. So the study was conducted to assess dental professionals' knowledge, attitude, and perception toward biostatistics at an academic dental institution. An anonymous cross-sectional questionnaire survey was conducted among all the faculty and postgraduate students of two dental colleges in Moradabad, Uttar Pradesh. The responses were assessed on 5-point likert scale. The survey response rate was 73.71%. Two-thirds of respondents believed biostatistics to be a difficult subject and at the same time half of them did not consider it to be more difficult than other subjects in dentistry. Females were less competent than males in applying biostatistical skills which was found to be statistically significant. Results suggested that dentists with research or academics as an adjunct to their clinical practice had better command over the subject. The current study shows that there is lack of command over the subject of biostatistics among dental professionals although they were aware of its importance in dentistry. There is a need of changing the training pattern of biostatistics for dental professionals which would make them confident enough to apply biostatistics in their clinical practice.

  5. Aiming for a holistic integrated service for men diagnosed with prostate cancer - Definitions of standards and skill sets for nurses and allied healthcare professionals.

    Science.gov (United States)

    Lamb, Alastair D; Thompson, Sue; Kinsella, Netty; Gerbitz, Ingmar; Chapman, Elaine; Putt, Lisa; Bennett, Sophie; Thankappannair, Vineetha; Geoghegan, Lisa; Wright, Naomi; Stirton-Croft, Alison; Nixon, Penny; Styling, Andrew; Whitney, Diane; Hodgson, Lindsay; Punt, Lisa; Longmore, Jenny; Carter, Mike; Petch, Bill; Rimmer, Yvonne; Russell, Simon; Hughes-Davies, Luke; Mazhar, Danish; Shah, Nimish C; Gnanapragasam, Vincent J; Doble, Andrew; Bratt, Ola; Kastner, Christof

    2017-08-01

    To establish a comprehensive set of recommendations for the service structure and skill set of nurses and allied healthcare professionals in prostate cancer care. Using components of formal consensus methodology, a 30-member multidisciplinary panel produced 53 items for discussion relating to the provision of care for prostate cancer patients by specialist nurses and allied healthcare professionals. Items were developed by two rounds of email correspondence in which, first, items were generated and, second, items refined to form the basis of a consensus meeting which constituted the third round of review. The fourth and final round was an email review of the consensus output. The panel agreed on 33 items that were appropriate for recommendations to be made. These items were grouped under categories of "Environment" and "Patient Pathway" and included comments on training, leadership, communication and quality assessment as well as specific items related to prostate diagnosis clinics, radical treatment clinics and follow-up survivor groups. Specialist nurses and allied healthcare professionals play a vital role alongside urologists and oncologists to provide care to men with prostate cancer and their families. We present a set of standards and consensus recommendations for the roles and skill-set required for these practitioners to provide gold-standard prostate cancer care. These recommendations could form the basis for development of comprehensive integrated prostate cancer pathways in prostate cancer centres as well as providing guidance for any units treating men with prostate cancer. Copyright © 2017. Published by Elsevier Ltd.

  6. Integrating ICT in Kenyan Secondary Schools: An Exploratory Case Study of a Professional Development Programme

    Science.gov (United States)

    Tondeur, Jo; Krug, Don; Bill, Mike; Smulders, Maaike; Zhu, Chang

    2015-01-01

    This study explores the introduction of Information and Communication Technology (ICT) in Kenyan secondary schools. Specifically, it is a case study of four schools with no previous access to ICT. The professional development programme from which data for this study were drawn was designed to support teachers learning to integrate ICT in the…

  7. Examining the Technology Integration Planning Cycle Model of Professional Development to Support Teachers' Instructional Practices

    Science.gov (United States)

    Hutchison, Amy C.; Woodward, Lindsay

    2018-01-01

    Background: Presently, models of professional development aimed at supporting teachers' technology integration efforts are often short and decontextualized. With many schools across the country utilizing standards that require students to engage with digital tools, a situative model that supports building teachers' knowledge within their…

  8. CLINICAL SURFACES -- Activity-Based Computing for Distributed Multi-Display Environments in Hospitals

    DEFF Research Database (Denmark)

    Bardram, Jakob Eyvind; Bunde-Pedersen, Jonathan; Doryab, Afsaneh

    2009-01-01

    A multi-display environment (MDE) is made up of co-located and networked personal and public devices that form an integrated workspace enabling co-located group work. Traditionally, MDEs have, however, mainly been designed to support a single “smart room”, and have had little sense of the tasks...

  9. Online virtual patients - A driver for change in medical and healthcare professional education in developing countries?

    Science.gov (United States)

    Dewhurst, David; Borgstein, Eric; Grant, Mary E; Begg, Michael

    2009-08-01

    The development of online virtual patients has proved to be an effective vehicle for pedagogical and technological skills transfer and capacity building for medical and healthcare educators in Malawi. A project between the University of Edinburgh and the University of Malawi has delivered more than 20 collaboratively developed, virtual patients, contextualised for in-country medical and healthcare education and, more significantly, a cadre of healthcare professionals skilled in developing digital resources and integrating these into their emerging curricula. The process of engaging with new approaches to teaching and delivering personalised, context sensitive content via a game-informed, technology-supported process has contributed to the ability of healthcare educators in Malawi to drive pedagogical change, meet the substantial challenges of delivering new curricula, cope with increasing student numbers and promote teacher professional development. This initial phase of the project has laid the foundation for a broader second phase that focuses on promoting curriculum change, developing educational infrastructure and in-country capacity to create, and integrate digital resources into education and training across multi-professional groups and across educational levels.

  10. Integrated shape and material selection for single and multi-performance criteria

    International Nuclear Information System (INIS)

    Singh, Jasveer; Mirjalili, Vahid; Pasini, Damiano

    2011-01-01

    Research highlights: → The method of shape transformers is extended to torsional stiffness and combined load design. → The method is generalized for multi-criteria selection of shape and material. → Performance charts are presented for single and multi-objective selection of cross-section shape and material. → A four quadrant performance chart is presented to visualize the relation between objective function space and design variable space. -- Abstract: A shape and material selection method, based on the concept of shape transformers, has been recently introduced to characterize the mass efficiency of lightweight beams under bending and shear. This paper extends this method to deal with the case of torsional stiffness design, and generalize it to single and multi-crieria selection of lightweight shafts subjected to a combination of bending, shear, and torsional load. The novel feature of the paper is the useful integration of shape and material to model and visualize multi-objective selection problems. The scheme is centered on concept selection in structural design, and hinges on measures that govern the shape properties of a cross-section regardless of its size. These measures, referred as shape transformers, can classify shapes in a way similar to material classification. The procedure is exemplified by considering torsional stiffness as a constraint. The performance charts are developed for single and multi-criteria to visualize in a glance the whole range of cross-sectional shapes for each material. Each design chart is explained with a brief example.

  11. Multi-soliton management by the integrable nonautonomous nonlinear integro-differential Schrödinger equation

    International Nuclear Information System (INIS)

    Zhang, Yu-Juan; Zhao, Dun; Luo, Hong-Gang

    2014-01-01

    We consider a wide class of integrable nonautonomous nonlinear integro-differential Schrödinger equation which contains the models for the soliton management in Bose–Einstein condensates, nonlinear optics, and inhomogeneous Heisenberg spin chain. With the help of the nonisospectral AKNS hierarchy, we obtain the N-fold Darboux transformation and the N-fold soliton-like solutions for the equation. The soliton management, especially the synchronized dispersive and nonlinear management in optical fibers is discussed. It is found that in the situation without external potential, the synchronized dispersive and nonlinear management can keep the integrability of the nonlinear Schrödinger equation; this suggests that in optical fibers, the synchronized dispersive and nonlinear management can control and maintain the propagation of a multi-soliton. - Highlights: • We consider a unified model for soliton management by an integrable integro-differential Schrödinger equation. • Using Lax pair, the N-fold Darboux transformation for the equation is presented. • The multi-soliton management is considered. • The synchronized dispersive and nonlinear management is suggested

  12. Integration of clinical research documentation in electronic health records.

    Science.gov (United States)

    Broach, Debra

    2015-04-01

    Clinical trials of investigational drugs and devices are often conducted within healthcare facilities concurrently with clinical care. With implementation of electronic health records, new communication methods are required to notify nonresearch clinicians of research participation. This article reviews clinical research source documentation, the electronic health record and the medical record, areas in which the research record and electronic health record overlap, and implications for the research nurse coordinator in documentation of the care of the patient/subject. Incorporation of clinical research documentation in the electronic health record will lead to a more complete patient/subject medical record in compliance with both research and medical records regulations. A literature search provided little information about the inclusion of clinical research documentation within the electronic health record. Although regulations and guidelines define both source documentation and the medical record, integration of research documentation in the electronic health record is not clearly defined. At minimum, the signed informed consent(s), investigational drug or device usage, and research team contact information should be documented within the electronic health record. Institutional policies should define a standardized process for this integration in the absence federal guidance. Nurses coordinating clinical trials are in an ideal position to define this integration.

  13. Pedagogical Work, Stress Regulation and Work-Related Well-Being among Early Childhood Professionals in Integrated Special Day-Care Groups

    Science.gov (United States)

    Nislin, Mari A.; Sajaniemi, Nina K.; Sims, Margaret; Suhonen, Eira; Maldonado Montero, Enrique F.; Hirvonen, Ari; Hyttinen, Sirpa

    2016-01-01

    The aim of this study was to investigate the relationship between early childhood professionals' (ECPs) stress regulation (using salivary cortisol and alpha-amylase [AA] measurements), work engagement and the quality of their pedagogical work in integrated special day-care groups. Participants were 89 ECPs from 21 integrated special day-care…

  14. A challenge to the rhetoric of emancipation: recreating a professional culture.

    Science.gov (United States)

    Clare, J

    1993-07-01

    This paper explores the notion that nursing education is a political process which reproduces traditional practices. There is evidence to suggest that dominant ideologies, embedded in the social processes of education and health care, shape the consciousness of nurse teachers and students towards conformity and compliance with established practices in hegemonic institutions. Traditional practices or 'common sense' reinforces the structural arrangements which contribute to the contradictions that students experience between knowledge they are 'given' in the classroom and knowledge they derive from their clinical learning experiences. It is clinical placements which bring students face to face with their position in the established hierarchy of knowledge, professional relationships and routinized practices. In this sense students may experience their classroom education as a denial of their lived experience in clinical settings. They may learn to negotiate among the different meanings and explanations they encounter and learn to act in ways that are personally and professionally 'safe', thereby reproducing traditional nursing culture. Project 2000 in Great Britain and the calls for a 'curriculum revolution' from North America promise transformation of traditional practice. But it is the political processes of teaching and learning and their practical effects which must be revealed for critique and transformation if professional ideals of reflective practice, emancipatory knowledge and professional autonomy are to play an integral part in transforming professional nursing practice within hegemonic institutions.

  15. PMAS: The Potsdam Multi-Aperture Spectrophotometer. II. The Wide Integral Field Unit PPak

    NARCIS (Netherlands)

    Kelz, Andreas; Verheijen, Marc A. W.; Roth, Martin M.; Bauer, Svend M.; Becker, Thomas; Paschke, Jens; Popow, Emil; Sánchez, Sebastian F.; Laux, Uwe

    2006-01-01

    PPak is a new fiber-based integral field unit (IFU) developed at the Astrophysical Institute of Potsdam and implemented as a module into the existing Potsdam Multi-Aperture Spectrophotometer (PMAS) spectrograph. The purpose of PPak is to provide an extended field of view with a large

  16. The learner’s perspective in GP teaching practices with multi-level learners: a qualitative study

    Science.gov (United States)

    2014-01-01

    Background Medical students, junior hospital doctors on rotation and general practice (GP) registrars are undertaking their training in clinical general practices in increasing numbers in Australia. Some practices have four levels of learner. This study aimed to explore how multi-level teaching (also called vertical integration of GP education and training) is occurring in clinical general practice and the impact of such teaching on the learner. Methods A qualitative research methodology was used with face-to-face, semi-structured interviews of medical students, junior hospital doctors, GP registrars and GP teachers in eight training practices in the region that taught all levels of learners. Interviews were audio-recorded and transcribed. Qualitative analysis was conducted using thematic analysis techniques aided by the use of the software package N-Vivo 9. Primary themes were identified and categorised by the co-investigators. Results 52 interviews were completed and analysed. Themes were identified relating to both the practice learning environment and teaching methods used. A practice environment where there is a strong teaching culture, enjoyment of learning, and flexible learning methods, as well as learning spaces and organised teaching arrangements, all contribute to positive learning from a learners’ perspective. Learners identified a number of innovative teaching methods and viewed them as positive. These included multi-level learner group tutorials in the practice, being taught by a team of teachers, including GP registrars and other health professionals, and access to a supernumerary GP supervisor (also termed “GP consultant teacher”). Other teaching methods that were viewed positively were parallel consulting, informal learning and rural hospital context integrated learning. Conclusions Vertical integration of GP education and training generally impacted positively on all levels of learner. This research has provided further evidence about the

  17. Integrative Data Analysis of Multi-Platform Cancer Data with a Multimodal Deep Learning Approach.

    Science.gov (United States)

    Liang, Muxuan; Li, Zhizhong; Chen, Ting; Zeng, Jianyang

    2015-01-01

    Identification of cancer subtypes plays an important role in revealing useful insights into disease pathogenesis and advancing personalized therapy. The recent development of high-throughput sequencing technologies has enabled the rapid collection of multi-platform genomic data (e.g., gene expression, miRNA expression, and DNA methylation) for the same set of tumor samples. Although numerous integrative clustering approaches have been developed to analyze cancer data, few of them are particularly designed to exploit both deep intrinsic statistical properties of each input modality and complex cross-modality correlations among multi-platform input data. In this paper, we propose a new machine learning model, called multimodal deep belief network (DBN), to cluster cancer patients from multi-platform observation data. In our integrative clustering framework, relationships among inherent features of each single modality are first encoded into multiple layers of hidden variables, and then a joint latent model is employed to fuse common features derived from multiple input modalities. A practical learning algorithm, called contrastive divergence (CD), is applied to infer the parameters of our multimodal DBN model in an unsupervised manner. Tests on two available cancer datasets show that our integrative data analysis approach can effectively extract a unified representation of latent features to capture both intra- and cross-modality correlations, and identify meaningful disease subtypes from multi-platform cancer data. In addition, our approach can identify key genes and miRNAs that may play distinct roles in the pathogenesis of different cancer subtypes. Among those key miRNAs, we found that the expression level of miR-29a is highly correlated with survival time in ovarian cancer patients. These results indicate that our multimodal DBN based data analysis approach may have practical applications in cancer pathogenesis studies and provide useful guidelines for

  18. Possibility of Integrated Data Mining of Clinical Data

    Directory of Open Access Journals (Sweden)

    Akinori Abe

    2007-03-01

    Full Text Available In this paper, we introduce integrated data mining. Because of recent rapid progress in medical science as well as clinical diagnosis and treatment, integrated and cooperative research among medical researchers, biology, engineering, cultural science, and sociology is required. Therefore, we propose a framework called Cyber Integrated Medical Infrastructure (CIMI. Within this framework, we can deal with various types of data and consequently need to integrate those data prior to analysis. In this study, for medical science, we analyze the features and relationships among various types of data and show the possibility of integrated data mining.

  19. Clinical multi-omics strategies for the effective cancer management.

    Science.gov (United States)

    Yoo, Byong Chul; Kim, Kyung-Hee; Woo, Sang Myung; Myung, Jae Kyung

    2017-08-15

    Cancer is a global health issue as a multi-factorial complex disease, and early detection and novel therapeutic strategies are required for more effective cancer management. With the development of systemic analytical -omics strategies, the therapeutic approach and study of the molecular mechanisms of carcinogenesis and cancer progression have moved from hypothesis-driven targeted investigations to data-driven untargeted investigations focusing on the integrated diagnosis, treatment, and prevention of cancer in individual patients. Predictive, preventive, and personalized medicine (PPPM) is a promising new approach to reduce the burden of cancer and facilitate more accurate prognosis, diagnosis, as well as effective treatment. Here we review the fundamentals of, and new developments in, -omics technologies, together with the key role of a variety of practical -omics strategies in PPPM for cancer treatment and diagnosis. In this review, a comprehensive and critical overview of the systematic strategy for predictive, preventive, and personalized medicine (PPPM) for cancer disease was described in a view of cancer prognostic prediction, diagnostics, and prevention as well as cancer therapy and drug responses. We have discussed multi-dimensional data obtained from various resources and integration of multisciplinary -omics strategies with computational method which could contribute the more effective PPPM for cancer. This review has provided the novel insights of the current applications of each and combined -omics technologies, which showed their powerful potential for the establishment of PPPM for cancer. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Voltage margin control for offshore multi-use platform integration

    DEFF Research Database (Denmark)

    Mier, V.; Casielles, P.G.; Koto, J.

    This paper discusses a multiterminal direct current (MTDC) connection proposed for integration of offshore multi-use platforms into continental grids. Voltage source converters (VSC) were selected for their suitability for multiterminal dc systems and for their flexibility in control. A five...... terminal VSC-MTDC which includes offshore generation, storage, loads and ac connection, was modeled and simulated in DigSILENT Power Factory software. Voltage margin method has been used for reliable operation of the MTDC system without the need of fast communication. Simulation results show......, sell or store energy attending to the price in the electricity market....

  1. Direct Support Professionals and Reversed Integration of People With Intellectual Disabilities : Impact of Attitudes, Perceived Social Norms, and Meta-Evaluations

    NARCIS (Netherlands)

    Venema, Eleonora; Otten, Sabine; Vlaskamp, Carla

    Direct support professionals (DSPs) play an important role in the process of integration of people with intellectual disabilities. Nevertheless, little is currently known about what determines the level of effort exerted by DSPs to enable the social integration of their clients. The aim of this

  2. Opening our hearts and minds: the meaning of international clinical nursing electives in the personal and professional lives of nurses.

    Science.gov (United States)

    Callister, Lynn Clark; Cox, Amy Harmer

    2006-06-01

    Although international opportunities are the hallmark of nursing education at a large private university, the meaning of participating in such clinical nursing electives has not been described. The purpose of this phenomenological study of nurses was to examine the personal and professional meaning of participating in international clinical nursing electives during their undergraduate nursing studies. Audiotaped interviews were conducted with 20 former nursing students who had had this opportunity. "Opening our hearts and minds" was described by the study's participants, with the following themes: increasing understanding of other cultures and peoples, increasing understanding of global sociopolitical and health issues, increasing the commitment to make a difference, experiencing personal and professional growth, contributing to professional development in the host country, making interpersonal connexions, and developing cultural competence. This study makes an important contribution to the documentation of the meaning of participating in international nursing clinical experiences. Data are being used for long-term curricular planning in the development and refinement of future international clinical nursing electives and to provide outcomes data for professional accreditation. There are broader implications for the movement beyond individual cultural competence to increasing global consciousness and the improvement of global health care.

  3. Clinical and economic benefits of professional CGM among people with type 2 diabetes in the United States: analysis of claims and lab data.

    Science.gov (United States)

    Sierra, Joseph A; Shah, Mona; Gill, Max S; Flores, Zachery; Chawla, Hiten; Kaufman, Francine R; Vigersky, Robert

    2018-03-01

    It is estimated that one in 10 people in the US have a diagnosis of diabetes. Type 2 diabetes accounts for 95% of all cases in the US, with annual costs estimated to be $246 billion per year. This study investigated the impact of a glucose-measuring intervention to the burden of type 2 diabetes. This analysis seeks to understand how professional continuous glucose monitoring (professional CGM) impacts clinical and economic outcomes when compared to patients who are not prescribed professional CGM. This study utilized a large healthcare claims and lab dataset from the US, and identified a cohort of patients who were prescribed professional CGM as identified by CPT codes 95250 and 95251. It calculated economic and clinical outcomes 1 year before and 1 year after the use of professional CGM, using a generalized linear model. Patients who utilized professional CGM saw an improvement in hemoglobin A1C. The "difference-in-difference" calculation for A1C was shown to be -0.44%. There was no statistically significant difference in growth of total annual costs for people who used professional CGM compared to those who did not ($1,270, p = .08). Patients using professional CGM more than once per year had a -$3,376 difference in the growth of total costs (p = .05). Patients who used professional CGM while changing their diabetes treatment regimen also had a difference of -$3,327 in growth of total costs (p = .0023). Significant clinical benefits were observed for patients who used professional CGM. Economic benefits were observed for patients who utilized professional CGM more than once within a 1-year period or who used it during a change of diabetes therapy. This suggests that professional CGM may help decrease rising trends in healthcare costs for people with type 2 diabetes, while also improving clinical outcomes.

  4. Wiki Activities in Blended Learning for Health Professional Students: Enhancing Critical Thinking and Clinical Reasoning Skills

    Science.gov (United States)

    Snodgrass, Suzanne

    2011-01-01

    Health professionals use critical thinking, a key problem solving skill, for clinical reasoning which is defined as the use of knowledge and reflective inquiry to diagnose a clinical problem. Teaching these skills in traditional settings with growing class sizes is challenging, and students increasingly expect learning that is flexible and…

  5. Simulation-based medical education in clinical skills laboratory.

    Science.gov (United States)

    Akaike, Masashi; Fukutomi, Miki; Nagamune, Masami; Fujimoto, Akiko; Tsuji, Akiko; Ishida, Kazuko; Iwata, Takashi

    2012-01-01

    Clinical skills laboratories have been established in medical institutions as facilities for simulation-based medical education (SBME). SBME is believed to be superior to the traditional style of medical education from the viewpoint of the active and adult learning theories. SBME can provide a learning cycle of debriefing and feedback for learners as well as evaluation of procedures and competency. SBME offers both learners and patients a safe environment for practice and error. In a full-environment simulation, learners can obtain not only technical skills but also non-technical skills, such as leadership, team work, communication, situation awareness, decision-making, and awareness of personal limitations. SBME is also effective for integration of clinical medicine and basic medicine. In addition, technology-enhanced simulation training is associated with beneficial effects for outcomes of knowledge, skills, behaviors, and patient-related outcomes. To perform SBME, effectively, not only simulators including high-fidelity mannequin-type simulators or virtual-reality simulators but also full-time faculties and instructors as professionals of SBME are essential in a clinical skills laboratory for SBME. Clinical skills laboratory is expected to become an integrated medical education center to achieve continuing professional development, integrated learning of basic and clinical medicine, and citizens' participation and cooperation in medical education.

  6. Interpreting and Integrating Clinical and Anatomic Pathology Results.

    Science.gov (United States)

    Ramaiah, Lila; Hinrichs, Mary Jane; Skuba, Elizabeth V; Iverson, William O; Ennulat, Daniela

    2017-01-01

    The continuing education course on integrating clinical and anatomical pathology data was designed to communicate the importance of using a weight of evidence approach to interpret safety findings in toxicology studies. This approach is necessary, as neither clinical nor anatomic pathology data can be relied upon in isolation to fully understand the relationship between study findings and the test article. Basic principles for correlating anatomic pathology and clinical pathology findings and for integrating these with other study end points were reviewed. To highlight these relationships, a series of case examples, presented jointly by a clinical pathologist and an anatomic pathologist, were used to illustrate the collaborative effort required between clinical and anatomical pathologists. In addition, the diagnostic utility of traditional liver biomarkers was discussed using results from a meta-analysis of rat hepatobiliary marker and histopathology data. This discussion also included examples of traditional and novel liver and renal biomarker data implementation in nonclinical toxicology studies to illustrate the relationship between discrete changes in biochemistry and tissue morphology.

  7. Adam M. Reid: APA/APAGS Award for Distinguished Graduate Student in Professional Psychology.

    Science.gov (United States)

    2015-11-01

    The APA/APAGS Award for Distinguished Graduate Student in Professional Psychology is awarded on an annual basis by the APA Board of Professional Affairs (BPA) and the American Psychological Association of Graduate Students (APAGS) to a graduate student who has demonstrated outstanding practice and application of psychology. One of the 2015 award winners is Adam M. Reid, who received this award "for his community service, in which he has integrated the highest standards of professional psychological clinical practice and science." Adam's award citation, biography, and a selected bibliography are presented here. (c) 2015 APA, all rights reserved).

  8. The Importance of Information Management for the Professional Performance of the Executive Secretary - an Integrative National Literature Review.

    Directory of Open Access Journals (Sweden)

    Nuriane Santos Montezano

    2015-08-01

    Full Text Available The article presents the reality of the new Executive Secretariat professional and its relation to the Strategic Information System. All the concepts were worked out based on the national integrative literature review. The aim was to determine what is the importance of information management and its applicability to the professional context of the Executive Secretariat. The discussion and theoretical reflection showed that the current Executive Secretary professional is prepared for the new organizational dynamics to incorporate technologically execution management information in context. This is another task that gives and confirms its multifunctional character as an important information manager figure in decision-making organizations.

  9. Emerging medical informatics with case-based reasoning for aiding clinical decision in multi-agent system.

    Science.gov (United States)

    Shen, Ying; Colloc, Joël; Jacquet-Andrieu, Armelle; Lei, Kai

    2015-08-01

    This research aims to depict the methodological steps and tools about the combined operation of case-based reasoning (CBR) and multi-agent system (MAS) to expose the ontological application in the field of clinical decision support. The multi-agent architecture works for the consideration of the whole cycle of clinical decision-making adaptable to many medical aspects such as the diagnosis, prognosis, treatment, therapeutic monitoring of gastric cancer. In the multi-agent architecture, the ontological agent type employs the domain knowledge to ease the extraction of similar clinical cases and provide treatment suggestions to patients and physicians. Ontological agent is used for the extension of domain hierarchy and the interpretation of input requests. Case-based reasoning memorizes and restores experience data for solving similar problems, with the help of matching approach and defined interfaces of ontologies. A typical case is developed to illustrate the implementation of the knowledge acquisition and restitution of medical experts. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Exploration of the affordances of mobile devices in integrating theory and clinical practice in an undergraduate nursing programme

    Directory of Open Access Journals (Sweden)

    Juliana J. Willemse

    2015-09-01

    Full Text Available Background: Promoting the quality and effectiveness of nursing education is an important factor, given the increased demand for nursing professionals. It is important to establish learning environments that provide personalised guidance and feedback to students about their practical skills and application of their theoretical knowledge. Objective: To explore and describe the knowledge and points of view of students and educators about introduction of new technologies into an undergraduate nursing programme. Method: The qualitative design used Tesch’s (1990 steps of descriptive data analysis to complete thematic analysis of the data collected in focus group discussions (FGDs andindividual interviews to identify themes. Results: Themes identified from the students’ FGDs and individual interviews included:mobile devices as a communication tool; email, WhatsApp and Facebook as methods of communication; WhatsApp as a method of communication; nurses as role-models in the clinical setting; setting personal boundaries; and impact of mobile devices in clinical practiceon professionalism. Themes identified from the FGD, individual interviews and a discussion session held with educators included: peer learning via mobile devices; email, WhatsApp and Facebook as methods of communication; the mobile device as a positive learning method; students need practical guidance; and ethical concerns in clinical facilities about Internet access and use of mobile devices. Conclusion: The research project established an understanding of the knowledge and points of view of students and educators regarding introduction of new technologies into an undergraduate nursing programme with the aim of enhancing integration of theory and clinical practice through use of mobile devices.

  11. Exploration of the affordances of mobile devices in integrating theory and clinical practice in an undergraduate nursing programme.

    Science.gov (United States)

    Willemse, Juliana J; Bozalek, Vivienne

    2015-01-01

    Promoting the quality and effectiveness of nursing education is an important factor, given the increased demand for nursing professionals. It is important to establish learning environments that provide personalised guidance and feedback to students about their practical skills and application of their theoretical knowledge. To explore and describe the knowledge and points of view of students and educators about introduction of new technologies into an undergraduate nursing programme. The qualitative design used Tesch's (1990) steps of descriptive data analysis to complete thematic analysis of the data collected in focus group discussions (FGDs) and individual interviews to identify themes. Themes identified from the students’ FGDs and individual interviews included: mobile devices as a communication tool; email, WhatsApp and Facebook as methods of communication; WhatsApp as a method of communication; nurses as role-models in the clinical setting; setting personal boundaries; and impact of mobile devices in clinical practice on professionalism. Themes identified from the FGD, individual interviews and a discussion session held with educators included: peer learning via mobile devices; email, WhatsApp and Facebook as methods of communication; the mobile device as a positive learning method; students need practical guidance; and ethical concerns in clinical facilities about Internet access and use of mobile devices. The research project established an understanding of the knowledge and points of view of students and educators regarding introduction of new technologies into an undergraduate nursing programme with the aim of enhancing integration of theory and clinical practice through use of mobile devices.

  12. Multi-symplectic integrators: numerical schemes for Hamiltonian PDEs that conserve symplecticity

    Science.gov (United States)

    Bridges, Thomas J.; Reich, Sebastian

    2001-06-01

    The symplectic numerical integration of finite-dimensional Hamiltonian systems is a well established subject and has led to a deeper understanding of existing methods as well as to the development of new very efficient and accurate schemes, e.g., for rigid body, constrained, and molecular dynamics. The numerical integration of infinite-dimensional Hamiltonian systems or Hamiltonian PDEs is much less explored. In this Letter, we suggest a new theoretical framework for generalizing symplectic numerical integrators for ODEs to Hamiltonian PDEs in R2: time plus one space dimension. The central idea is that symplecticity for Hamiltonian PDEs is directional: the symplectic structure of the PDE is decomposed into distinct components representing space and time independently. In this setting PDE integrators can be constructed by concatenating uni-directional ODE symplectic integrators. This suggests a natural definition of multi-symplectic integrator as a discretization that conserves a discrete version of the conservation of symplecticity for Hamiltonian PDEs. We show that this approach leads to a general framework for geometric numerical schemes for Hamiltonian PDEs, which have remarkable energy and momentum conservation properties. Generalizations, including development of higher-order methods, application to the Euler equations in fluid mechanics, application to perturbed systems, and extension to more than one space dimension are also discussed.

  13. Enabling multi-level relevance feedback on PubMed by integrating rank learning into DBMS.

    Science.gov (United States)

    Yu, Hwanjo; Kim, Taehoon; Oh, Jinoh; Ko, Ilhwan; Kim, Sungchul; Han, Wook-Shin

    2010-04-16

    Finding relevant articles from PubMed is challenging because it is hard to express the user's specific intention in the given query interface, and a keyword query typically retrieves a large number of results. Researchers have applied machine learning techniques to find relevant articles by ranking the articles according to the learned relevance function. However, the process of learning and ranking is usually done offline without integrated with the keyword queries, and the users have to provide a large amount of training documents to get a reasonable learning accuracy. This paper proposes a novel multi-level relevance feedback system for PubMed, called RefMed, which supports both ad-hoc keyword queries and a multi-level relevance feedback in real time on PubMed. RefMed supports a multi-level relevance feedback by using the RankSVM as the learning method, and thus it achieves higher accuracy with less feedback. RefMed "tightly" integrates the RankSVM into RDBMS to support both keyword queries and the multi-level relevance feedback in real time; the tight coupling of the RankSVM and DBMS substantially improves the processing time. An efficient parameter selection method for the RankSVM is also proposed, which tunes the RankSVM parameter without performing validation. Thereby, RefMed achieves a high learning accuracy in real time without performing a validation process. RefMed is accessible at http://dm.postech.ac.kr/refmed. RefMed is the first multi-level relevance feedback system for PubMed, which achieves a high accuracy with less feedback. It effectively learns an accurate relevance function from the user's feedback and efficiently processes the function to return relevant articles in real time.

  14. LINKS: learning-based multi-source IntegratioN frameworK for Segmentation of infant brain images.

    Science.gov (United States)

    Wang, Li; Gao, Yaozong; Shi, Feng; Li, Gang; Gilmore, John H; Lin, Weili; Shen, Dinggang

    2015-03-01

    Segmentation of infant brain MR images is challenging due to insufficient image quality, severe partial volume effect, and ongoing maturation and myelination processes. In the first year of life, the image contrast between white and gray matters of the infant brain undergoes dramatic changes. In particular, the image contrast is inverted around 6-8months of age, and the white and gray matter tissues are isointense in both T1- and T2-weighted MR images and thus exhibit the extremely low tissue contrast, which poses significant challenges for automated segmentation. Most previous studies used multi-atlas label fusion strategy, which has the limitation of equally treating the different available image modalities and is often computationally expensive. To cope with these limitations, in this paper, we propose a novel learning-based multi-source integration framework for segmentation of infant brain images. Specifically, we employ the random forest technique to effectively integrate features from multi-source images together for tissue segmentation. Here, the multi-source images include initially only the multi-modality (T1, T2 and FA) images and later also the iteratively estimated and refined tissue probability maps of gray matter, white matter, and cerebrospinal fluid. Experimental results on 119 infants show that the proposed method achieves better performance than other state-of-the-art automated segmentation methods. Further validation was performed on the MICCAI grand challenge and the proposed method was ranked top among all competing methods. Moreover, to alleviate the possible anatomical errors, our method can also be combined with an anatomically-constrained multi-atlas labeling approach for further improving the segmentation accuracy. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. An action research protocol to strengthen system-wide inter-professional learning and practice [LP0775514

    Directory of Open Access Journals (Sweden)

    Travaglia Joanne

    2007-09-01

    Full Text Available Abstract Background Inter-professional learning (IPL and inter-professional practice (IPP are thought to be critical determinants of effective care, improved quality and safety and enhanced provider morale, yet few empirical studies have demonstrated this. Whole-of-system research is even less prevalent. We aim to provide a four year, multi-method, multi-collaborator action research program of IPL and IPP in defined, bounded health and education systems located in the Australian Capital Territory (ACT. The project is funded by the Australian Research Council under its industry Linkage Program. Methods/Design The program of research will examine in four inter-related, prospective studies, progress with IPL and IPP across tertiary education providers, professional education, regulatory and registration bodies, the ACT health system's streams of care activities and teams, units and wards of the provider facilities of the ACT health system. One key focus will be on push-pull mechanisms, ie, how the education sector creates student-enabled IPP and the health sector demands IPL-oriented practitioners. The studies will examine four research aims and meet 20 research project objectives in a comprehensive evaluation of ongoing progress with IPL and IPP. Discussion IPP and IPL are said to be cornerstones of health system reforms. We will measure progress across an entire health system and the clinical and professional education systems that feed into it. The value of multi-methods, partnership research and a bi-directional push-pull model of IPL and IPP will be tested. Widespread dissemination of results to practitioners, policymakers, managers and researchers will be a key project goal.

  16. [Clinical retrospective control study of single-port laparoendoscopic and multi-port laparoscopic ovarian cystectomy].

    Science.gov (United States)

    Liu, X; Wen, M K; Liu, H Y; Sun, D W; Lang, J H; Fan, Q B; Shi, H H

    2017-10-25

    Objective: To investigate clinical outcomes of laparoendoscopic single-site ovarian cystectomy compared with traditional multi-port laparoscopic ovarian cystectomy. Methods: Data of 81 patients with ovarian cystectomy from January 2016 to May 2017, the single-site group ( n= 40) and the multi-port group ( n= 41) in Peking Union Medical College Hospital were retrospectively collected. The outcomes of single-site and multi-port groups were analyzed and compared, including: postoperative fever, operation time, blood loss, hemoglobin change, surgical complications, postoperative pain score, postoperative analgesic requirements, body image scale and cosmetic score, length of hospital stay, postoperative total cost. Results: No complication was found in two groups. No difference was found in postoperative fever, blood loss, hemoglobin change, postoperative pain score, length of hospital stay, and total cost between the two groups (all P> 0.05). Operation time was (50±20) minutes in single-site group, and (40±15) minutes in multi-port group; postoperative analgesic requirements was 28%(11/40) in single-site group, and 7%(4/41) in multi-port group; cosmetic score was 22.6±2.6 in single-site group, and 17.3±2.6 in multi-port group; body image scale was 5.7±1.2 in single-site group, and 6.2±1.2 in multi-port group; these four clinical parameters were statistical differences (all P< 0.05). Conculsion: Laparoendoscopic single-site ovarian cystectomy is feasible and safe, although it could't relieve the postoperative pian, it do offer a higher cosmetic satisfaction.

  17. Positioning for vertical integration through clinics "without walls".

    Science.gov (United States)

    Johnson, B A; Schryver, D L

    1994-01-01

    Authors Bruce A. Johnson, J.D., M.P.A., and Darrell Schryver, D.P.A., offer the clinic without walls model as a transitory step to full vertical integration. They write that this model "may enable physicians to address the key issues associated with managed care and integration in a more gradual, controlled fashion.

  18. An integrative review of the impact of mobile technologies used by healthcare professionals to support education and practice.

    Science.gov (United States)

    Guo, Ping; Watts, Kim; Wharrad, Heather

    2016-04-01

    The aim of this study was to provide evidence of the impact of mobile technologies among healthcare professionals in education and practice settings. Integrative literature review. Electronic databases including MEDLINE, CINAHL, PsycINFO, EMBASE, ERIC and Web of Science were searched for papers published between 2002-2012. Quantitative studies were critically evaluated based on Thomas et al .'s framework, while the consolidated criteria for reporting qualitative research was used to appraise the rigour of the qualitative studies. Seventeen quantitative and three qualitative studies were included. The findings suggest a largely positive influence of mobile technologies on various clinical practice and educational outcomes. However, robust evidence was limited. Use of mobile technologies in health care are associated with improvements in access to information, accuracy and efficiency, evidence-based decision making at the point of care and enhancement in performance, confidence and engagement in different contexts.

  19. Ethics and Professionalism in Pathology

    Directory of Open Access Journals (Sweden)

    R Baral

    2016-03-01

    Full Text Available Pathologists spend most of their professional lives beyond direct view of the public, mostly inside the four walls of the lab. It is the clinicians who face the wrath of the public when something goes wrong. However, with the growing awareness of the public into the decisive role played by the Pathologists in the definitive diagnosis of the disease, the pathologists will soon be the target of the aggrieved patients and relatives.1 The issue of ethics can be dealt when professionalism comes before profession. "Professionalism in medicine requires that physician serve the interests of the patient above his or her own selfinterest." Professionalism aspires to philanthropy, answerability, excellence, duty, service and respect for others. "Professionalism in Pathology is based on the same tenets, but has additional dimensions."The qualities of professionalism for pathologists include 1. Communication with the patients and the clinicians. A small phone call with the clinician will solve most of the clinical mysteries not written in the lab requisition forms; 2. Empathy and Compassion towards patients', colleagues', and laboratory personnel's culture, age, gender, and disabilities; 3. Demonstration of passion, respect and understanding towards the patients; 4. Adherence to guidelines and regulations of the regulatory and accrediting bodies; and 5.Profeciency and knowledge in one's work is valued by the patients more than the credentials, which also enables one to identify deficiencies in peer performance. The basic competencies of professionalism are vital to every pathology report, which in turn is the mirror of the ethics practiced by the pathologist. Evaluating oneself is perhaps the most important tool in maintaining professionalism in the practice of pathology. One colleague recently defined professionalism as “all the things one does when no one is watching,” thus placing personal integrity at the top of the list.

  20. Ethical sensitivity in professional practice: concept analysis.

    Science.gov (United States)

    Weaver, Kathryn; Morse, Janice; Mitcham, Carl

    2008-06-01

    This paper is a report of a concept analysis of ethical sensitivity. Ethical sensitivity enables nurses and other professionals to respond morally to the suffering and vulnerability of those receiving professional care and services. Because of its significance to nursing and other professional practices, ethical sensitivity deserves more focused analysis. A criteria-based method oriented toward pragmatic utility guided the analysis of 200 papers and books from the fields of nursing, medicine, psychology, dentistry, clinical ethics, theology, education, law, accounting or business, journalism, philosophy, political and social sciences and women's studies. This literature spanned 1970 to 2006 and was sorted by discipline and concept dimensions and examined for concept structure and use across various contexts. The analysis was completed in September 2007. Ethical sensitivity in professional practice develops in contexts of uncertainty, client suffering and vulnerability, and through relationships characterized by receptivity, responsiveness and courage on the part of professionals. Essential attributes of ethical sensitivity are identified as moral perception, affectivity and dividing loyalties. Outcomes include integrity preserving decision-making, comfort and well-being, learning and professional transcendence. Our findings promote ethical sensitivity as a type of practical wisdom that pursues client comfort and professional satisfaction with care delivery. The analysis and resulting model offers an inclusive view of ethical sensitivity that addresses some of the limitations with prior conceptualizations.

  1. From organizational integration to clinical integration: analysis of the path between one level of integration to another using official documents

    Science.gov (United States)

    Mandza, Matey; Gagnon, Dominique; Carrier, Sébastien; Belzile, Louise; Demers, Louis

    2010-01-01

    Purpose Services’ integration comprises organizational, normative, economic, informational and clinical dimensions. Since 2004, the province of Quebec has devoted significant efforts to unify the governance of the main health and social care organizations of its various territories. Notwithstanding the uniformity of the national plan’s prescription, the territorial integration modalities greatly vary across the province. Theory This research is based upon a conceptual model of integration that comprises six components: inter-organizational partnership, case management, standardized assessment, a single entry point, a standardized service planning tool and a shared clinical file. Methods We conducted an embedded case study in six contrasted sites in terms of their level of integration. All documents prescribing the implementation of integration were retrieved and analyzed. Results and conclusions The analyzed documents demonstrate a growing local appropriation of the current integrative reform. Interestingly however, no link seems to exist between the quality of local prescriptions and the level of integration achieved in each site. This finding leads us to hypothesize that the variable quality of the operational accompaniment offered to implement these prescriptions is a variable in play.

  2. An Integrated Method for Interval Multi-Objective Planning of a Water Resource System in the Eastern Part of Handan

    Directory of Open Access Journals (Sweden)

    Meiqin Suo

    2017-07-01

    Full Text Available In this study, an integrated solving method is proposed for interval multi-objective planning. The proposed method is based on fuzzy linear programming and an interactive two-step method. It cannot only provide objectively optimal values for multiple objectives at the same time, but also effectively offer a globally optimal interval solution. Meanwhile, the degree of satisfaction related to different objective functions would be obtained. Then, the integrated solving method for interval multi-objective planning is applied to a case study of planning multi-water resources joint scheduling under uncertainty in the eastern part of Handan, China. The solutions obtained are useful for decision makers in easing the contradiction between supply of multi-water resources and demand from different water users. Moreover, it can provide the optimal comprehensive benefits of economy, society, and the environment.

  3. [Professional competence of the graduates of the clinical residency and internship in the speciality 31.08.10 'forensic medical expertise'].

    Science.gov (United States)

    Kovalev, A V; Romanenko, G Kh; Makarov, I Yu; Zharov, V V; Bereznikov, A V

    The objective of the present study was the definition of the basic professional competences of the graduates of the clinical residency and internship in the speciality 31.08.10 'forensic medical expertise'. The program for the acquirement of the basic knowledge, skills, and professional competences needed to be trained in the speciality 31.08.10 'forensic medical expertise' has been elaborated in the framework of the more extensive program for the clinical residency and internship intended for the training of the highly qualified specialists in this discipline. The preliminary list of basic professional competences of a graduate from the clinical residency and internship has been formulated in accordance with the program for the training of a competitive and highly qualified forensic medical experts. The practical professional activities are considered to be an indispensable component of the training and educational process for a future forensic medical expert. It is believed that the strengthening of this training component will greatly contribute to the improvement of the quality of training of such specialists.

  4. Integrative veterinary medical education and consensus guidelines ...

    African Journals Online (AJOL)

    Increased training of future veterinary professionals in IVM may produce an openness to new ideas that characterizes the scientific method and a willingness to pursue and incorporate evidence-based medicine in clinical practice with all therapies, including those presently regarded as integrative, complementary, ...

  5. New Proposals for the Design of Integrated Online Wine Industry Dictionaries

    DEFF Research Database (Denmark)

    Leroyer, Patrick

    2013-01-01

    Abstract: The specialised lexicographic treatment of oenology and viticulture usually consists in the compiling of articles describing the language of wine in general language dictionaries, or presenting professional knowledge of wine in specialised multi-field dictionaries and encyclopedias. Thi...... dictionaries should not stand alone, as they could benefit from a full integration with the websites of the wine industry, and consequently transform into genuine lexicographic information tools.......Abstract: The specialised lexicographic treatment of oenology and viticulture usually consists in the compiling of articles describing the language of wine in general language dictionaries, or presenting professional knowledge of wine in specialised multi-field dictionaries and encyclopedias....... This treatment also encompasses the terminological compilation of single field dictionaries describing the language and/or knowledge of wine. Lexicographically speaking, all this is but a fraction of the complete picture. Indeed, the specialised lexicography of oenology and viticulture is multifaceted and goes...

  6. Exploring the perspectives of clinical professionals and support staff on implementing supported self-management for asthma in UK general practice: an IMP2ART qualitative study.

    Science.gov (United States)

    Morrow, Susan; Daines, Luke; Wiener-Ogilvie, Sharon; Steed, Liz; McKee, Lorna; Caress, Ann-Louise; Taylor, Stephanie J C; Pinnock, Hilary

    2017-07-18

    Despite an overwhelming evidence base, supported self-management of asthma is poorly implemented into routine practice. Strategies for implementation must address organisational routines, as well as provide resources for patients and training to improve professionals' skills. We aimed to explore the priority that primary care practices attach to asthma self-management, to describe their existing asthma management routines, and to generate innovative implementation strategies. We recruited 33 participants (23 general practitioners; seven nurses; three administrative staff) from 14 general practices. The 12 interviews and three focus groups were transcribed, coded and analysed thematically. Supported self-management was largely a nurse-led task within clinic-based annual reviews. Barriers included poor attendance at asthma clinics, lack of time, demarcation of roles, limited access to a range of tailored resources, and competing agendas in consultation, often due to multimorbidity. Suggestions for initiatives to improve the provision of supported self-management included emphasising the evidence for benefit (to influence prioritisation), improving teamwork (including team-based education), organisational strategies (including remote consulting) which need to fit within existing practice routines. Technology offers some potential solutions (e.g., improved templates, 'app'-based plans), but must be integrated with the practice information technology systems. Building on these insights, we will now develop a theoretically-based implementation strategy that will address patient, professional, and organisational buy-in, provide team-based education and offer a range of practical options and tools, which can be adapted and integrated within existing routines of individual practices.OVERCOMING THE ORGANISATIONAL BARRIERS TO IMPLEMENTING ASTHMA SELF-MANAGEMENT: Understanding the routines of primary care practices can suggest strategies to implement supported self

  7. Identifying the barriers to conducting outcomes research in integrative health care clinic settings - a qualitative study

    Directory of Open Access Journals (Sweden)

    Findlay-Reece Barbara

    2010-01-01

    Full Text Available Abstract Background Integrative health care (IHC is an interdisciplinary blending of conventional medicine and complementary and alternative medicine (CAM with the purpose of enhancing patients' health. In 2006, we designed a study to assess outcomes that are relevant to people using such care. However, we faced major challenges in conducting this study and hypothesized that this might be due to the lack of a research climate in these clinics. To investigate these challenges, we initiated a further study in 2008, to explore the reasons why IHC clinics are not conducting outcomes research and to identify strategies for conducting successful in-house outcomes research programs. The results of the latter study are reported here. Methods A total of 25 qualitative interviews were conducted with key participants from 19 IHC clinics across Canada. Basic content analysis was used to identify key themes from the transcribed interviews. Results Barriers identified by participants fell into four categories: organizational culture, organizational resources, organizational environment and logistical challenges. Cultural challenges relate to the philosophy of IHC, organizational leadership and practitioner attitudes and beliefs. Participants also identified significant issues relating to their organization's lack of resources such as funding, compensation, infrastructure and partnerships/linkages. Environmental challenges such as the nature of a clinic's patient population and logistical issues such as the actual implementation of a research program and the applicability of research data also posed challenges to the conduct of research. Embedded research leadership, integration of personal and professional values about research, alignment of research activities and clinical workflow processes are some of the factors identified by participants that support IHC clinics' ability to conduct outcomes research. Conclusions Assessing and enhancing the broader

  8. Properties, promotive and obstructive conditions of multi-professional teaching and learning of health professions and non-health professions: an explorative survey from the perspective of teachers.

    Science.gov (United States)

    Schmitz, Daniela; Höhmann, Ulrike

    2016-01-01

    Care for people with dementia is considered a multi-professional challenge that requires a collaborative approach between health professionals and non-health professionals. Didactic strategies to ensure the same qualifications across these occupational groups are lacking. This article presents the joint learning of selected properties and promotive and obstructive conditions, using the example of a multi-professional Master's programme. It subsequently draws conclusions for didactic concepts. The perceptions of 12 teachers on this Master's programme, all representing different professions, were determined by using a qualitative exploratory survey on the three stated dimensions. With the aid of a summarising content analysis, their statements were condensed and abstracted so as to deduce appropriate requirements for methodical and didactic learning scenarios. In view of the fact that the students have very varied previous knowledge, the main challenge is finding a balance between expertise and tediousness. Establishing essential and common expertise, as well as sensitivity for different perspectives, is made particularly difficult by the fact that health and non-health professions differ greatly in terms of methods and approaches. For a successful outcome, the content focal points and didactic and methodical concepts for a learning group need to take into account the composition of that specific group. Recourse to didactic standard concepts is only possible to a limited extent. The aim of joint teaching and learning of health and non-health professionals is to enhance the understanding of a profession: This is done by making individuals aware of their role in the chain of care, so they can recognise and organise the mutual conditionality of their own and external professional contributions.

  9. The effect of multi-professional education on the recognition and outcome of patients at risk on general wards

    DEFF Research Database (Denmark)

    Fuhrmann, L.; Perner, A.; Klausen, T.W.

    2009-01-01

    The aim of this study was to evaluate the effect of multi-professional full-scale simulation-based education of staff on the mortality and staff awareness of patients at risk on general wards. DESIGN, SETTINGS AND PATIENTS: A prospective before-and-after study conducted on four general wards...... at Herlev Hospital, Denmark. In the pre-intervention period (June-July 2006) and post-intervention period (November-December 2007), all patients on the wards had vital signs measured in the evening by study personnel, who also asked nursing staff questions about patients with abnormal vital signs...

  10. Load Situation Awareness Design for Integration in Multi-Energy System

    DEFF Research Database (Denmark)

    Cai, Hanmin; You, Shi; Bindner, Henrik W.

    2017-01-01

    Renewable Energy Sources (RESs) have been penetrating in power system at a staggering pace in recent years. Their intermittent nature is, however, posing great threat to system operation. Recently, active load management has been suggested as a tool to counteract these side effects. In multi......-energy system, thermal load management will benefit not only electric network but also district heating network. Electric heater will be the main focus of this paper as a common thermal load. A situation awareness framework for its integration into electric and district heating network will be proposed...

  11. Impacts of Professional Development in Integrated STEM Education on Teacher Self-Efficacy, Outcome Expectancy, and Stem Career Awareness

    Science.gov (United States)

    Knowles, J. Geoff

    This research analyzed the effects of teacher professional development and lesson implementation in integrated Science, Technology, Engineering, and Math (STEM) on: 1.) Teacher self-efficacy and their confidence to teach specific STEM subjects; 2.) Teaching outcome expectancy beliefs concerning the impact of actions by teachers on student learning; and 3.) Teacher awareness of STEM careers. High school science and technology education teachers participating in the Teachers and Researchers Advancing Integrated Lessons in STEM (TRAILS) project experimental group attended a ten-day summer professional development institute designed to educate teachers in using an integrated STEM education model to implement integrated STEM lessons. The research design utilized a quasi-experimental nonequivalent comparison group design that incorporated an experimental group and an untreated comparison group with both pretest, posttest, and delayed posttest assessments on non-randomized participants. Teacher self-efficacy has been identified as a key factor in effective teaching and student learning, and teacher awareness of STEM careers impacts students as they consider career choices. The T-STEM Survey for teachers was given for the pretest and posttest assessments to measure attitudes and beliefs toward the specific constructs of this study. Significant effects of the TRAILS professional development were found in the teacher group (experimental or comparison) and teacher subject (technology or science) in pretest and posttest scores using cumulative link models for the constructs of teacher self-efficacy and beliefs to teach STEM subjects, teacher outcome expectancy beliefs, and teacher awareness of STEM careers. Effect sizes ranged from small to large varying by construct and assessment time. Highly significant p-values and effect sizes revealed impacts on science teachers were greater when teacher subject groups were analyzed separately.

  12. Health-care professionals' knowledge, attitudes and behaviours relating to patient capacity to consent to treatment: an integrative review.

    Science.gov (United States)

    Lamont, Scott; Jeon, Yun-Hee; Chiarella, Mary

    2013-09-01

    This integrative review aims to provide a synthesis of research findings of health-care professionals' knowledge, attitudes and behaviours relating to patient capacity to consent to or refuse treatment within the general hospital setting. Search strategies included relevant health databases, hand searching of key journals, 'snowballing' and expert recommendations. The review identified various knowledge gaps and attitudinal dispositions of health-care professionals, which influence their behaviours and decision-making in relation to capacity to consent processes. The findings suggest that there is tension between legal, ethical and professional standards relating to the assessment of capacity and consent within health care. Legislation and policy guidance concerning capacity assessment processes are lacking, and this may contribute to inconsistencies in practice.

  13. An ultra-dense integrated linkage map for hexaploid chrysanthemum enables multi-allelic QTL analysis

    NARCIS (Netherlands)

    Geest, van Geert; Bourke, Peter M.; Voorrips, Roeland E.; Marasek-Ciolakowska, Agnieszka; Liao, Yanlin; Post, Aike; Meeteren, van Uulke; Visser, Richard G.F.; Maliepaard, Chris; Arens, Paul

    2017-01-01

    Key message: We constructed the first integrated genetic linkage map in a polysomic hexaploid. This enabled us to estimate inheritance of parental haplotypes in the offspring and detect multi-allelic QTL.Abstract: Construction and use of linkage maps are challenging in hexaploids with polysomic

  14. Pediatric travel consultation in an integrated clinic.

    Science.gov (United States)

    Christenson , J C; Fischer , P R; Hale , D C; Derrick , D

    2001-01-01

    In May 1997, a pediatric travel service was created within a larger integrated University-County Health Department international travel clinic. The purpose of the service was to further enhance the travel advice and care provided to children and their parents or guardians. The current study was designed to describe the care of children in this setting and to compare the care of children seen in the Pediatric Travel Service with that of children seen by other providers. All pediatric patients (defined as individuals Mexico, South America, and Southeast Asia. When compared to travelers seen in the Regular Clinic, individuals in the Pediatric Travel Service group were more likely to travel for humanitarian work, and for parental work relocation. Persons in the Regular Clinic were more likely to travel to Mexico and Central America. They were also more likely to travel on vacation and for missionary work or study. Hepatitis B and tetanus-diphtheria booster vaccinations were given more frequently to travelers seen in the Regular Clinic. Also, ciprofloxacin and antimotility agents were more commonly prescribed in this group. No differences were noted in the duration of travel or in the time interval between clinic visit and departure. While general travel advice was considered to be similar in both clinic groups, some differences were observed in the frequency of administration of certain vaccines and prescriptions of medications. These differences were likely due to a difference in age in the two study groups. The high volume and success of the clinic suggest that integrated pediatric and adult travel services in a coordinated setting can be effective.

  15. Efficient Simulation of Compressible, Viscous Fluids using Multi-rate Time Integration

    Science.gov (United States)

    Mikida, Cory; Kloeckner, Andreas; Bodony, Daniel

    2017-11-01

    In the numerical simulation of problems of compressible, viscous fluids with single-rate time integrators, the global timestep used is limited to that of the finest mesh point or fastest physical process. This talk discusses the application of multi-rate Adams-Bashforth (MRAB) integrators to an overset mesh framework to solve compressible viscous fluid problems of varying scale with improved efficiency, with emphasis on the strategy of timescale separation and the application of the resulting numerical method to two sample problems: subsonic viscous flow over a cylinder and a viscous jet in crossflow. The results presented indicate the numerical efficacy of MRAB integrators, outline a number of outstanding code challenges, demonstrate the expected reduction in time enabled by MRAB, and emphasize the need for proper load balancing through spatial decomposition in order for parallel runs to achieve the predicted time-saving benefit. This material is based in part upon work supported by the Department of Energy, National Nuclear Security Administration, under Award Number DE-NA0002374.

  16. Addressing narcissistic personality features in the context of medical care: integrating diverse perspectives to inform clinical practice.

    Science.gov (United States)

    Magidson, J F; Collado-Rodriguez, A; Madan, A; Perez-Camoirano, N A; Galloway, S K; Borckardt, J J; Campbell, W K; Miller, J D

    2012-04-01

    Narcissistic personality disorder (NPD) is characterized by an unrealistic need for admiration, lack of empathy toward others, and feelings of superiority. NPD presents a unique and significant challenge in clinical practice, particularly in medical settings with limited provider contact time, as health professionals treat individuals who often require excessive admiration and have competing treatment needs. This practice review highlights real case examples across three distinct medically oriented clinical settings (inpatient and outpatient behavioral medicine and a Level I trauma center) to demonstrate the difficult and compromising situations that providers face when treating patients with general medical conditions and comorbid narcissistic personality features. The main goal of this article is to discuss the various challenges and obstacles associated with these cases in medical settings and discuss some strategies that may prove successful. A second goal is to bridge diverse conceptualizations of narcissism/NPD through the discussion of theoretical and empirical perspectives that can inform understanding of the clinical examples. Despite differing perspectives regarding the underlying motivation of narcissistic behavior, this practice review highlights that these paradigms can be integrated when sharing the same ultimate goal: to improve delivery of care across medically oriented clinical settings for patients with narcissistic features.

  17. An integrated analog O/E/O link for multi-channel laser neurons

    Energy Technology Data Exchange (ETDEWEB)

    Nahmias, Mitchell A., E-mail: mnahmias@princeton.edu; Tait, Alexander N.; Tolias, Leonidas; Chang, Matthew P.; Ferreira de Lima, Thomas; Shastri, Bhavin J.; Prucnal, Paul R. [Electrical Engineering Department, Princeton University, 41 Olden St, Princeton, New Jersey 08540 (United States)

    2016-04-11

    We demonstrate an analog O/E/O electronic link to allow integrated laser neurons to accept many distinguishable, high bandwidth input signals simultaneously. This device utilizes wavelength division multiplexing to achieve multi-channel fan-in, a photodetector to sum signals together, and a laser cavity to perform a nonlinear operation. Its speed outpaces accelerated-time neuromorphic electronics, and it represents a viable direction towards scalable networking approaches.

  18. Roles for Information professionals in patient education: Librarians' perspective

    Directory of Open Access Journals (Sweden)

    Susan L. MacDonald

    2010-07-01

    Full Text Available Through an examination of librarians’ contributions to the PEPTalk research project, this article highlights roles for information professionals at various stages in the design and clinical implementation of an information system that delivers patient education. The Personal Education Plan (PEPTalk was a collaborative, multi-disciplinary research project (2005-2006 based at the University Health Network’s Princess Margaret Hospital that designed an information system to provide web-based health information resources to both patients and clinicians under a shared umbrella of patient education. This article provides an overview of the PEPTalk project methods and outcomes, and documents the contributions of librarians throughout the design and clinical implementation stages of the project. Librarians brought expertise about information seeking behaviours of both patients and clinicians to the project; liaised across institutional and professional boundaries; developed a classification system for online learning objects, and educated project team about information and health literacies. The contributions of librarians on the PEPTalk project illustrate the need for boundary spanners, information brokers, knowledge translators, and change champions in the design and implementation of patient education delivery systems. There are new roles emergent at the intersections of clinical practice and health information provision. There is a need for the traditional skills and expertise of librarians and other information professionals in tailoring health information. Yet the design and implementation of patient education systems also require the development of new skills and the application of advanced information literacy as it pertains to both clinicians and patients.

  19. Rapid Integration of Multi-copy Transgenes Using Optogenetic Mutagenesis in Caenorhabditis elegans

    Directory of Open Access Journals (Sweden)

    Kentaro Noma

    2018-06-01

    Full Text Available Stably transmitted transgenes are indispensable for labeling cellular components and manipulating cellular functions. In Caenorhabditis elegans, transgenes are generally generated as inheritable multi-copy extrachromosomal arrays, which can be stabilized in the genome through a mutagenesis-mediated integration process. Standard methods to integrate extrachromosomal arrays primarily use protocols involving ultraviolet light plus trimethylpsoralen or gamma- or X-ray irradiation, which are laborious and time-consuming. Here, we describe a one-step integration method, following germline-mutagenesis induced by mini Singlet Oxygen Generator (miniSOG. Upon blue light treatment, miniSOG tagged to histone (Histone-miniSOG generates reactive oxygen species (ROS and induces heritable mutations, including DNA double-stranded breaks. We demonstrate that we can bypass the need to first establish extrachromosomal transgenic lines by coupling microinjection of desired plasmids with blue light illumination on Histone-miniSOG worms to obtain integrants in the F3 progeny. We consistently obtained more than one integrant from 12 injected animals in two weeks. This optogenetic approach significantly reduces the amount of time and labor for transgene integration. Moreover, it enables to generate stably expressed transgenes that cause toxicity in animal growth.

  20. Professional competencies in health sciences education: from multiple intelligences to the clinic floor.

    Science.gov (United States)

    Lane, India F

    2010-03-01

    Nontechnical competencies identified as essential to the health professional's success include ethical behavior, interpersonal, self-management, leadership, business, and thinking competencies. The literature regarding such diverse topics, and the literature regarding "professional success" is extensive and wide-ranging, crossing educational, psychological, business, medical and vocational fields of study. This review is designed to introduce ways of viewing nontechnical competence from the psychology of human capacity to current perspectives, initiatives and needs in practice. After an introduction to the tensions inherent in educating individuals for both biomedical competency and "bedside" or "cageside" manner, the paper presents a brief overview of the major lines of inquiry into intelligence theory and how theories of multiple intelligences can build a foundation for conceptualizing professional and life skills. The discussion then moves from broad concepts of intelligence to more specific workplace skill sets, with an emphasis on professional medical education. This section introduces the research on noncognitive variables in various disciplines, the growing emphasis on competency based education, and the SKA movement in veterinary education. The next section presents the evidence that nontechnical, noncognitive or humanistic skills influence achievement in academic settings, medical education and clinical performance, as well as the challenges faced when educational priorities must be made.

  1. Wireless Synchronization of a Multi-Pinhole Small Animal SPECT Collimation Device With a Clinical Scanner

    Science.gov (United States)

    DiFilippo, Frank P.; Patel, Sagar

    2009-06-01

    A multi-pinhole collimation device for small animal single photon emission computed tomography (SPECT) uses the gamma camera detectors of a standard clinical SPECT scanner. The collimator and animal bed move independently of the detectors, and therefore their motions must be synchronized. One approach is manual triggering of the SPECT acquisition simultaneously with a programmed motion sequence for the device. However, some data blurring and loss of image quality result, and true electronic synchronization is preferred. An off-the-shelf digital gyroscope with integrated Bluetooth interface provides a wireless solution to device synchronization. The sensor attaches to the SPECT gantry and reports its rotational speed to a notebook computer controlling the device. Software processes the rotation data in real-time, averaging the signal and issuing triggers while compensating for baseline drift. Motion commands are sent to the collimation device with minimal delay, within approximately 0.5 second of the start of SPECT gantry rotation. Test scans of a point source demonstrate an increase in true counts and a reduction in background counts compared to manual synchronization. The wireless rotation sensor provides robust synchronization of the collimation device with the clinical SPECT scanner and enhances image quality.

  2. Multi-Professional Panics in the Aftermath of Refugee Arrivals

    DEFF Research Database (Denmark)

    Padovan-Özdemir, Marta; Øland, Trine

    professional journals are included representing four major welfare professions (teachers, social educators, nurses and social workers: Folkeskolen [The Public Community School], Børn & Unge [Children & Adolescents], Sygeplejersken [The Nurse], Socialrådgiveren [The Social Worker]. Included are also two...... four major welfare professions; teacher, social educators, nurses, and social workers. The refugee family as a shared object of problematisation and intervention is what binds these professional groups together in the historical educational practices under investigation. For example, professionals...... express concerns regarding single male refugees (without family), polygamous refugee families, unaccompanied refugee children (broken families), dysfunctional (traumatised) families etc.Analytical questions that reflect a theoretically informed understanding the object of study based on readings...

  3. Evaluating impact of a multi-dimensional education programme on perceived performance of primary care professionals in diabetes care.

    Science.gov (United States)

    Parekh, Sanjoti; Bush, Robert; Cook, Susan; Grant, Phillipa

    2015-11-01

    The purpose of this study is to evaluate an educational programme, 'Diabetes Connect: Connecting Professions', which was developed to enhance communication across primary care networks, to support best practice in clinical interventions and progress multidisciplinary team work to benefit patients in diabetes care. A total of 26 workshops were successfully delivered for 309 primary care professionals across the state of Queensland in Australia from November 2011. It consists of two separate, but complementary training elements: a series of online clinical education training modules and state-wide interprofessional learning workshops developed to enhance professional competencies. The evaluation design included completion of online surveys by the participants at two time points: first upon registering for the online modules or workshops; second, one week after attending a workshop. The survey included questions to evaluate the change in role performance measures. Overall, significant increases in participants' current knowledge, perceived ability to adopt this knowledge at work and willingness to change professional behaviour in the short term were observed. The study suggests that for maximum benefit both, workshop and online training, should be combined and made available widely. Future programmes should use a randomised trial design to test the delivery model.

  4. Using Continuing Professional Development to Create Meaningful Co-Curricular Learning Opportunities for all Student Pharmacists.

    Science.gov (United States)

    Vos, Susan S; Sabus, Ashley; Seyfer, Jennifer; Umlah, Laura; Gross-Advani, Colleen; Thompson-Oster, Jackie

    2018-05-01

    Objective. To illustrate a method for integrating co-curricular activities, quantify co-curricular activities, and evaluate student perception of achievement of goals. Methods. Throughout a longitudinal course, students engaged in self-selected, co-curricular activities in three categories: professional service, leadership, and community engagement. Hours were documented online with minimum course requirements. Students reflected on experiences and assessed goal attainment. Assignments were reviewed by faculty and feedback was given to each student. Results. From 2010 to 2016, there were 29,341 co-curricular hours documented by 756 students. The most popular events were attending pharmacy organization meetings and participating in immunization clinics. More than half of the students agreed they were able to meet all of their professional goals (mix of career and course goals) while 70% indicated goals were challenging to meet. Conclusion. This method for integrating co-curricular activities using a continuing professional development model demonstrates a sustainable system for promoting professional development through experience and self-reflection.

  5. State of the Art and Challenges for Offshore Integrated Multi-Trophic Aquaculture (IMTA

    Directory of Open Access Journals (Sweden)

    Bela H. Buck

    2018-05-01

    Full Text Available By moving away from coastal waters and hence reducing pressure on nearshore ecosystems, offshore aquaculture can be seen as a possible step towards the large-scale expansion of marine food production. Integrated multi-trophic aquaculture (IMTA in nearshore water bodies has received increasing attention and could therefore play a role in the transfer of aquaculture operations to offshore areas. IMTA holds scope for multi-use of offshore areas and can bring environmental benefits from making use of waste products and transforming these into valuable co-products. Furthermore, they may act as alternative marine production systems and provide scope for alternative income options for coastal communities, e.g., by acting as nodes for farm operation and maintenance requirements. This paper summarizes the current state of knowledge on the implications of the exposed nature of offshore and open ocean sites on the biological, technological and socio-economic performance of IMTA. Of particular interest is improving knowledge about resource flows between integrated species in hydrodynamic challenging conditions that characterize offshore waters.

  6. Positive nondecreasing solutions for a multi-term fractional-order functional differential equation with integral conditions

    OpenAIRE

    Ahmed M. A. El-Sayed; Ebtisam O. Bin-Taher

    2011-01-01

    In this article, we prove the existence of positive nondecreasing solutions for a multi-term fractional-order functional differential equations. We consider Cauchy boundary problems with: nonlocal conditions, two-point boundary conditions, integral conditions, and deviated arguments.

  7. A multi-disciplinary approach for the integrated assessment of multiple risks in delta areas.

    Science.gov (United States)

    Sperotto, Anna; Torresan, Silvia; Critto, Andrea; Marcomini, Antonio

    2016-04-01

    The assessment of climate change related risks is notoriously difficult due to the complex and uncertain combinations of hazardous events that might happen, the multiplicity of physical processes involved, the continuous changes and interactions of environmental and socio-economic systems. One important challenge lies in predicting and modelling cascades of natural and man -made hazard events which can be triggered by climate change, encompassing different spatial and temporal scales. Another regard the potentially difficult integration of environmental, social and economic disciplines in the multi-risk concept. Finally, the effective interaction between scientists and stakeholders is essential to ensure that multi-risk knowledge is translated into efficient adaptation and management strategies. The assessment is even more complex at the scale of deltaic systems which are particularly vulnerable to global environmental changes, due to the fragile equilibrium between the presence of valuable natural ecosystems and relevant economic activities. Improving our capacity to assess the combined effects of multiple hazards (e.g. sea-level rise, storm surges, reduction in sediment load, local subsidence, saltwater intrusion) is therefore essential to identify timely opportunities for adaptation. A holistic multi-risk approach is here proposed to integrate terminology, metrics and methodologies from different research fields (i.e. environmental, social and economic sciences) thus creating shared knowledge areas to advance multi risk assessment and management in delta regions. A first testing of the approach, including the application of Bayesian network analysis for the assessment of impacts of climate change on key natural systems (e.g. wetlands, protected areas, beaches) and socio-economic activities (e.g. agriculture, tourism), is applied in the Po river delta in Northern Italy. The approach is based on a bottom-up process involving local stakeholders early in different

  8. Integrating Clinical Neuropsychology into the Undergraduate Curriculum.

    Science.gov (United States)

    Puente, Antonio E.; And Others

    1991-01-01

    Claims little information exists in undergraduate education about clinical neuropsychology. Outlines an undergraduate neuropsychology course and proposes ways to integrate the subject into existing undergraduate psychology courses. Suggests developing specialized audio-visual materials for telecourses or existing courses. (NL)

  9. Integrated risk assessment for multi-unit NPP sites—A comparison

    International Nuclear Information System (INIS)

    Kumar, C. Senthil; Hassija, Varun; Velusamy, K.; Balasubramaniyan, V.

    2015-01-01

    Highlights: • Framework for integrated risk assessment for multi-unit NPP sites. • Categorization of external and internal events. • Modelling of key issues: mission time, cliff-edge, common cause failures, etc. • Safety goals for multi-unit NPP sites. • Comparison of site core damage frequency in one, two, three and four unit sites. - Abstract: Most of the nuclear power producing sites in the world houses multiple units. Such sites are faced with hazards generated from external events: earthquake, tsunami, flood, etc. and can threaten the safety of nuclear power plants. Further, risk from a multiple unit site and its impact on the public and environment was evident during the Fukushima nuclear disaster in March 2011. It is therefore important to evolve a methodology to systematically assess the risk from multi-unit site. For a single unit site, probabilistic risk assessment technique identifies the potential accident scenarios, their consequences, and estimates the core damage frequency that arise due to internal and external hazards. This challenging task becomes even more complex for a multiple unit site, especially when the external hazards that has the potential to generate one or more correlated hazards or a combination of non-correlated hazards are to be modelled. This paper presents an approach to evaluate risk for multiple NPP sites and also compare the risk for sites housing single, double and multiple nuclear plants.

  10. Integrated risk assessment for multi-unit NPP sites—A comparison

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, C. Senthil, E-mail: cskumar@igcar.gov.in [AERB-Safety Research Institute, Kalpakkam (India); Hassija, Varun; Velusamy, K. [Reactor Design Group, Indira Gandhi Centre for Atomic Research, Kalpakkam (India); Balasubramaniyan, V. [AERB-Safety Research Institute, Kalpakkam (India)

    2015-11-15

    Highlights: • Framework for integrated risk assessment for multi-unit NPP sites. • Categorization of external and internal events. • Modelling of key issues: mission time, cliff-edge, common cause failures, etc. • Safety goals for multi-unit NPP sites. • Comparison of site core damage frequency in one, two, three and four unit sites. - Abstract: Most of the nuclear power producing sites in the world houses multiple units. Such sites are faced with hazards generated from external events: earthquake, tsunami, flood, etc. and can threaten the safety of nuclear power plants. Further, risk from a multiple unit site and its impact on the public and environment was evident during the Fukushima nuclear disaster in March 2011. It is therefore important to evolve a methodology to systematically assess the risk from multi-unit site. For a single unit site, probabilistic risk assessment technique identifies the potential accident scenarios, their consequences, and estimates the core damage frequency that arise due to internal and external hazards. This challenging task becomes even more complex for a multiple unit site, especially when the external hazards that has the potential to generate one or more correlated hazards or a combination of non-correlated hazards are to be modelled. This paper presents an approach to evaluate risk for multiple NPP sites and also compare the risk for sites housing single, double and multiple nuclear plants.

  11. [What is professionalism?].

    Science.gov (United States)

    Ohbu, Sadayoshi

    2012-01-01

    What is a profession? According to Cruess, it is an occupation whose core element is work that is based on the mastery of a complex body of knowledge and skills. It is a vocation in which knowledge of some department of science or learning, or the practice of an art founded on it, is used in the service of others. Its members profess a commitment to competence, integrity, morality, altruism, and the promotion of the public good within their domain. These commitments form the basis of a social contract between a profession and society, which in return grants the profession autonomy in practice and the privilege of self-regulation. Although medical professionals share the role of healer, there are wide variations between individuals. Professionalism is the basis of medicine's contract with society. Public trust is essential to that contract, and public trust depends on the integrity of both individual professionals and the whole profession. The introduction to this important symposium includes definitions of professions and of medical professionalism. It also includes discussions of reciprocal altruism, conflicts of interest in medical societies, the theory of cognitive dissonance, and the moral foundations of professionalism.

  12. Organization-based self-development prescriptive model for the promotion of professional development of Iranian clinical nurses

    Directory of Open Access Journals (Sweden)

    Flora Rahimaghaee

    2015-01-01

    Conclusions: Through this model, clinical nurses′ professional development can transform the profession from an individual, randomized activity into more planned and systematized services. This model can lead to a better quality of care.

  13. Comparison of Multi-Criteria Decision Support Methods for Integrated Rehabilitation Prioritization

    Directory of Open Access Journals (Sweden)

    Franz Tscheikner-Gratl

    2017-01-01

    Full Text Available The decisions taken in rehabilitation planning for the urban water networks will have a long lasting impact on the functionality and quality of future services provided by urban infrastructure. These decisions can be assisted by different approaches ranging from linear depreciation for estimating the economic value of the network over using a deterioration model to assess the probability of failure or the technical service life to sophisticated multi-criteria decision support systems. Subsequently, the aim of this paper is to compare five available multi-criteria decision-making (MCDM methods (ELECTRE, AHP, WSM, TOPSIS, and PROMETHEE for the application in an integrated rehabilitation management scheme for a real world case study and analyze them with respect to their suitability to be used in integrated asset management of water systems. The results of the different methods are not equal. This occurs because the chosen score scales, weights and the resulting distributions of the scores within the criteria do not have the same impact on all the methods. Independently of the method used, the decision maker must be familiar with its strengths but also weaknesses. Therefore, in some cases, it would be rational to use one of the simplest methods. However, to check for consistency and increase the reliability of the results, the application of several methods is encouraged.

  14. Measuring Professional Behaviour in Canadian Physical Therapy Students' Objective Structured Clinical Examinations: An Environmental Scan

    Science.gov (United States)

    Ellerton, Cindy; Evans, Cathy

    2015-01-01

    ABSTRACT Purpose: To identify professional behaviours measured in objective structured clinical examinations (OSCEs) by Canadian university physical therapy (PT) programs. Method: A cross-sectional telephone survey was conducted to review current practice and determine which OSCE items Canadian PT programs are using to measure PT students' professional behaviours. Telephone interviews using semi-structured questions were conducted with individual instructors responsible for courses that included an OSCE as part of the assessment component. Results: Nine PT programmes agreed to take part in the study, and all reported conducting at least one OSCE. The number and characteristics of OSCEs varied both within and across programs. Participants identified 31 professional behaviour items for use in an OSCE; these items clustered into four categories: communication (n=14), respect (n=10), patient safety (n=4), and physical therapists' characteristics (n=3). Conclusions: All Canadian entry-level PT programmes surveyed assess professional behaviours in OSCE-type examinations; however, the content and style of assessment is variable. The local environment should be considered when determining what professional behaviours are appropriate to assess in the OSCE context in individual programmes. PMID:25931656

  15. Sharing clinical information across care settings: the birth of an integrated assessment system

    Directory of Open Access Journals (Sweden)

    Henrard Jean-Claude

    2009-04-01

    Full Text Available Abstract Background Population ageing, the emergence of chronic illness, and the shift away from institutional care challenge conventional approaches to assessment systems which traditionally are problem and setting specific. Methods From 2002, the interRAI research collaborative undertook development of a suite of assessment tools to support assessment and care planning of persons with chronic illness, frailty, disability, or mental health problems across care settings. The suite constitutes an early example of a "third generation" assessment system. Results The rationale and development strategy for the suite is described, together with a description of potential applications. To date, ten instruments comprise the suite, each comprising "core" items shared among the majority of instruments and "optional" items that are specific to particular care settings or situations. Conclusion This comprehensive suite offers the opportunity for integrated multi-domain assessment, enabling electronic clinical records, data transfer, ease of interpretation and streamlined training.

  16. Sharing clinical information across care settings: the birth of an integrated assessment system

    Science.gov (United States)

    Gray, Leonard C; Berg, Katherine; Fries, Brant E; Henrard, Jean-Claude; Hirdes, John P; Steel, Knight; Morris, John N

    2009-01-01

    Background Population ageing, the emergence of chronic illness, and the shift away from institutional care challenge conventional approaches to assessment systems which traditionally are problem and setting specific. Methods From 2002, the interRAI research collaborative undertook development of a suite of assessment tools to support assessment and care planning of persons with chronic illness, frailty, disability, or mental health problems across care settings. The suite constitutes an early example of a "third generation" assessment system. Results The rationale and development strategy for the suite is described, together with a description of potential applications. To date, ten instruments comprise the suite, each comprising "core" items shared among the majority of instruments and "optional" items that are specific to particular care settings or situations. Conclusion This comprehensive suite offers the opportunity for integrated multi-domain assessment, enabling electronic clinical records, data transfer, ease of interpretation and streamlined training. PMID:19402891

  17. Multi-sensory integration in brainstem and auditory cortex.

    Science.gov (United States)

    Basura, Gregory J; Koehler, Seth D; Shore, Susan E

    2012-11-16

    Tinnitus is the perception of sound in the absence of a physical sound stimulus. It is thought to arise from aberrant neural activity within central auditory pathways that may be influenced by multiple brain centers, including the somatosensory system. Auditory-somatosensory (bimodal) integration occurs in the dorsal cochlear nucleus (DCN), where electrical activation of somatosensory regions alters pyramidal cell spike timing and rates of sound stimuli. Moreover, in conditions of tinnitus, bimodal integration in DCN is enhanced, producing greater spontaneous and sound-driven neural activity, which are neural correlates of tinnitus. In primary auditory cortex (A1), a similar auditory-somatosensory integration has been described in the normal system (Lakatos et al., 2007), where sub-threshold multisensory modulation may be a direct reflection of subcortical multisensory responses (Tyll et al., 2011). The present work utilized simultaneous recordings from both DCN and A1 to directly compare bimodal integration across these separate brain stations of the intact auditory pathway. Four-shank, 32-channel electrodes were placed in DCN and A1 to simultaneously record tone-evoked unit activity in the presence and absence of spinal trigeminal nucleus (Sp5) electrical activation. Bimodal stimulation led to long-lasting facilitation or suppression of single and multi-unit responses to subsequent sound in both DCN and A1. Immediate (bimodal response) and long-lasting (bimodal plasticity) effects of Sp5-tone stimulation were facilitation or suppression of tone-evoked firing rates in DCN and A1 at all Sp5-tone pairing intervals (10, 20, and 40 ms), and greater suppression at 20 ms pairing-intervals for single unit responses. Understanding the complex relationships between DCN and A1 bimodal processing in the normal animal provides the basis for studying its disruption in hearing loss and tinnitus models. This article is part of a Special Issue entitled: Tinnitus Neuroscience

  18. ANALYSIS OF ENVIRONMENTAL FRAGILITY USING MULTI-CRITERIA ANALYSIS (MCE FOR INTEGRATED LANDSCAPE ASSESSMENT

    Directory of Open Access Journals (Sweden)

    Abimael Cereda Junior

    2014-01-01

    Full Text Available The Geographic Information Systems brought greater possibilitie s to the representation and interpretation of the landscap e as well as the integrated a nalysis. However, this approach does not dispense technical and methodological substan tiation for achieving the computational universe. This work is grounded in ecodynamic s and empirical analysis of natural and anthr opogenic environmental Fragility a nd aims to propose and present an integrated paradigm of Multi-criteria Analysis and F uzzy Logic Model of Environmental Fragility, taking as a case study of the Basin of Monjolinho Stream in São Carlos-SP. The use of this methodology allowed for a reduct ion in the subjectivism influences of decision criteria, which factors might have its cartographic expression, respecting the complex integrated landscape.

  19. Professionalism--a required CLS/CLT curricular component.

    Science.gov (United States)

    Latshaw, Sandra; Honeycutt, Karen

    2010-01-01

    Determine the impact of requiring Clinical Laboratory Science (CLS) students to participate in approved professionalism activities as part of a mandatory management course. Quasi-experimental, case study reporting qualitative results of 25 CLS students. During the admission interview, students complete a written response to questions about their perceptions related to professionalism. During the clinical educational year, students are required to complete approved professionalism activities as part of a management course. At the end of the course, students write a reflective paper focusing on their professional activities and how these experiences will influence their future professional practice. Overall themes of student reflections are provided. University of Nebraska Medical Center (UNMC) CLS Program in Omaha. After participating in a mandatory professionalism curricular component requiring active student participation in professional activities, student reflective writings provide evidence this is one successful approach to nurture professional identity within future Clinical Laboratory Science/Clinical Laboratory Technician (CLS/CLT) practitioners.

  20. Multi-Professional Panics in the Aftermath of Refugee Arrivals

    DEFF Research Database (Denmark)

    Padovan-Özdemir, Marta; Øland, Trine

    the organisations’ websites. Older material has been retrieved from the library collection of education and educational research at Aarhus University, Emdrup, Copenhagen, and from The Collection of Pamphlets and Corporate Publications at the Royal Library, Copenhagen.Articles, announcements, job adds, etc......In the Summer of 2015, in all European welfare nation-states professionals, policy makers, administrators, and civil society organisations were in highest alert over the major refugee arrivals from Afghanistan, Syria, and the African continent. In Denmark, in particular, the government responded...... four major welfare professions; teacher, social educators, nurses, and social workers. The refugee family as a shared object of problematisation and intervention is what binds these professional groups together in the historical educational practices under investigation. For example, professionals...

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